Pediatrics hip fracture: Case series

Abstract

Objectives: Show the results obtained, describing the management and experience, knowing that the surgical delay time is much higher than that recommended in the current guidelines.
Materials and method: Retrospective study of consecutive cases of hip fractures in the range of 0-16 years, with a minimum follow-up of 12 months. Where epidemiological variables were analyzed, delay in arrival at the Hospital, delay in surgical treatment, complications and functionality according to the Ratliff criteria.
Results: Twenty-one cases of hip fractures. An average age of 9 years, 71% left-sided involvement, one case of bilateral presentation. The trauma mechanism was 42.8% related to a traffic accident. There were associated injuries in 33.3%. Predominance of type IV and type III according to the Delbet classification. Surgical treatment in 95% of cases. The delay in arrival at the hospital was 1.6 days on average, with a delay in treatment of 5.45 days. Average follow-up of 29 months (12-54 months). Excellent functional results were obtained in 66.6% of cases, fair in 23.8%, and poor results in 9.5. Complications occurred in 7 cases, with NOA in 19% of patients, coxa vara in 8.5%, and length discrepancy in 4% (4%).
Conclusions: They are rare fractures. As pediatric orthopedists, we must be up-to-date in the management of each type of injury, in order to offer the appropriate treatment that reduces the sequelae that may potentially exist. The goal should be to obtain anatomical reductions and stable fixations. And surgical delay is not synonymous with poor results.