Fractures of the Neck of the Femur in Children

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Experience in a series of seventy-five femoral-neck fractures in children has led to the following conclusions:1. The transepiphyseal fracture is rare and the results in the two examples reported in this series were poor.2. Unsdisplaced transcervical and cervicotrochansteric fractures can be adequately treated by simple immobilization in plaster of Paris.3. Minimally displaced transcervical and cervicotrochanteric fractures, in which considerable contact between the fragments has been maintained, should be reduced by manipulation and immobilized in plaster of Paris.4. Displaced transcervical and cervicotrochansteric fractures, especially if all bone constact has been lost, remain an unsolved problem. The experience herein reported cannot form the basis of any firm advice about their primary management, except to warn against the use of trifin mails for internal fixation.5. All pertrochanteric fractures in children can be satisfactorily treated by conservative measures.6. All fractures of the femoral neck ins children with the exception of pathological fractures can eventually be made to unite by bone, although bone-grafting will sometimes be necessary.7. The incidence of avascular necrosis ins this series was lower than in most previous reports. Its over-all incidence was 17 per cent in patients seen early.S. Premature epiphyseal fusions occurs in about 17 per cent of patients witin fresh fractures.9. Coxa vara is the commonest complication, but it is not incompatible with a good result and in the very young may be much modified by remodeling during the process of growth.

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