Clinical outcomes and risk factors for complications after closed reduction and internal fixation of pediatric femoral neck fractures
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Pediatric femoral neck fractures are rare but may lead to severe complications. This study aimed to evaluate clinical outcomes after closed reduction and internal fixation in pediatric femoral neck fractures and to identify risk factors associated with post-operative complications. METHODS: A retrospective analysis was performed on 41 pediatric patients (mean age, 10.6 years) treated with closed reduction and internal fixation. The mean follow-up period was 64 months (25-160). Demographic variables, fracture type, displacement, time to surgery, reduction quality, fixation method, and physeal penetration were analyzed as potential risk factors. Recorded complications included avascular necrosis (AVN), premature physeal closure (PPC), non-union, limb shortening, coxa vara, and coxa valga. Clinical outcomes were evaluated according to the Ratliff classification. RESULTS: Fracture union was achieved in 95.1% of patients. Initial displacement and reduction quality were significantly associated with both clinical outcomes and complication rates (p<0.05). Delayed surgery was linked to a higher incidence of AVN (p=0.013). Physeal penetration was associated with worse clinical outcomes, especially an increased risk of PPC (p=0.002) and AVN (p=0.031). CONCLUSION: Pediatric femoral neck fractures remain associated with high complication rates. Initial displacement, inappropriate reduction, prolonged time to surgery, and physeal penetration were found to be risk factors for complications. Early anatomical reduction and physeal-sparing fixation are key to improving outcomes.
Institution: Gaziantep University
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7225307828