Pathological progress of traumatic femur head necrosis after femoral neck fracture in children and adolescents: a case series study.
Journal
Journal of hip preservation surgery
ISSN: 2054-8397
Titre abrégé: J Hip Preserv Surg
Pays: England
ID NLM: 101643347
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
15
01
2021
accepted:
15
03
2021
entrez:
11
8
2021
pubmed:
12
8
2021
medline:
12
8
2021
Statut:
epublish
Résumé
The pathological progression and prognosis of traumatic femur head necrosis (TFHN) after femoral neck fracture (FNF) in children and adolescent is relatively unknown and has never been specifically characterized. As we speculated, the prognosis in such population would be poor and characterized as the high risk of femoral head collapse, hip deformity and degeneration in a short term. This retrospective case series enrolled 64 children and adolescent with TFHN who treated with observational treatment from 2000.1 to 2018.1. The primary outcomes, the progression of femoral head collapse, hip deformity (Stulberg classification) and hip degeneration (Tönnis grade), and their prognostic factors were analysed. Sixty-four patients with a mean age of 13 years (6-16 years) were included. A total of 28 hips (44%) showed unsatisfactory outcome and 25 (39%) hips collapsed progressively during a mean follow-up of 48 months (24-203 months). Finally, 38 hips (59%) experienced hip deformity, 20 of them were Class IV/V. Thirty-four hips (53%) generally progressed to osteoarthritis, 14 of them were classified as Grades II/III. The location of the lesion and the presence of subluxation were found to be related to progression of collapse; however, the presence of subluxation was the only independent risk factor of severe hip deformity and degeneration. TFHN in children and adolescent is a rapidly progressing disease with a poor prognosis characterized by a high risk of femoral head collapse progression. If the subluxation emerged, collapsed cases showed increasingly tendency towards hip deformity and degeneration.
Identifiants
pubmed: 34377512
doi: 10.1093/jhps/hnab025
pii: hnab025
pmc: PMC8349579
doi:
Types de publication
Journal Article
Langues
eng
Pagination
696-704Informations de copyright
© The Author(s) 2021. Published by Oxford University Press.
Références
Bone Joint J. 2019 Sep;101-B(9):1160-1167
pubmed: 31474136
Int Orthop. 2012 Jan;36(1):149-57
pubmed: 21796335
J Hip Preserv Surg. 2020 Apr 02;7(2):249-255
pubmed: 33163209
J Bone Joint Surg Br. 2008 Jul;90(7):940-5
pubmed: 18591607
J Pediatr Orthop. 2011 Sep;31(2 Suppl):S152-5
pubmed: 21857430
Bone Joint J. 2013 Jan;95-B(1):135-42
pubmed: 23307688
J Bone Joint Surg Br. 1962 Aug;44-B:528-42
pubmed: 14038616
Int Orthop. 2018 Jul;42(7):1449-1455
pubmed: 29455348
Eur J Radiol. 2019 Mar;112:1-6
pubmed: 30777197
J Bone Joint Surg Am. 2015 Oct 7;97(19):1604-27
pubmed: 26446969
J Bone Joint Surg Am. 2007 Aug;89(8):1727-34
pubmed: 17671011
J Bone Joint Surg Br. 2008 Oct;90(10):1364-71
pubmed: 18827249
PLoS Med. 2007 Oct 16;4(10):e297
pubmed: 17941715
Orthopedics. 2015 Nov;38(11):e983-90
pubmed: 26558678
J Bone Joint Surg Am. 2008 Nov;90 Suppl 4:47-66
pubmed: 18984718
J Hip Preserv Surg. 2020 Jul 02;7(2):329-339
pubmed: 33163219
Clin Orthop Relat Res. 2002 Jul;(400):149-57
pubmed: 12072757
J Bone Joint Surg Am. 1977 Jun;59(4):431-43
pubmed: 863935
J Bone Joint Surg Am. 1981 Sep;63(7):1095-108
pubmed: 7276045
Injury. 2003 May;34(4):283-6
pubmed: 12667781
Proc R Soc Med. 1962 Jun;55:504-5
pubmed: 14490536
J Bone Joint Surg Br. 2011 Oct;93(10):1314-9
pubmed: 21969428
J Pediatr Orthop. 1992 May-Jun;12(3):355-8
pubmed: 1573001
Sci Rep. 2016 Aug 01;6:30730
pubmed: 27477836
Clin Orthop Relat Res. 2004 Dec;(429):131-8
pubmed: 15577477
J Orthop Sci. 2002;7(5):601-5
pubmed: 12355139
Arch Orthop Unfallchir. 1972;72(1):1-9
pubmed: 5020681
Injury. 1972 Aug;4(1):41-6
pubmed: 4665145
J Child Orthop. 2009 Aug;3(4):259-64
pubmed: 19468776
J Pediatr Orthop. 1992 Jul-Aug;12(4):503-9
pubmed: 1613096
J Bone Joint Surg Br. 2001 Jul;83(5):715-20
pubmed: 11476312