Among all pediatric fractures, femoral neck fracture is an infrequent injury that occurs due to high-energy trauma. The high risk of complications, such as avascular necrosis (AVN), which is the most common and serious complication, coxa vara, nonunion, premature physeal closure and infections, turns this fracture into an orthopedic emergency and increases the need for early treatment and intervention. Among the classifications of femoral neck fractures, which are known as the Delbet classification, type 1 is the least common but with the highest risk of AVN. Therapeutic action for these patients is close or open reduction with internal fixation under general anesthesia, which according to the evidences, open reduction is a more successful method. Due to the high probability of complications and the urgent need for treatment of femoral neck fracture, early intervention and timely treatment should be performed. Here, we report a 14-year-old boy who was brought to the emergency department with a Delbet type 1B fracture of the left femoral neck with detached epiphyseal portion of the femoral head due to a car accident. After one failed attempt to closed reduction, open reduction and internal fixation with a posterolateral (Kocher) approach was performed under general anesthesia. The reduction was maintained with guide pins and fixed with cannulated screws. After 8 months of follow-up, AVN was noticed.
Case Rep Orthop Res 2022;5:24–30

中文翻译：

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青少年Delbet I型股骨颈骨折致缺血性坏死：一例报告及文献复习

在所有儿科骨折中，股骨颈骨折是一种由于高能量创伤而发生的罕见损伤。并发症的高风险，例如最常见和最严重的并发症缺血性坏死 (AVN)、髋内翻、骨不连、骺板过早闭合和感染，将这种骨折变成了骨科急症，增加了早期治疗和干预的需要. 在被称为 Delbet 分类的股骨颈骨折分类中，1 型是最不常见的，但 AVN 的风险最高。对这些患者的治疗措施是全身麻醉下闭合复位或切开复位内固定，有证据表明切开复位是比较成功的方法。股骨颈骨折由于并发症发生概率高，治疗急需，应早期干预，及时治疗。在这里，我们报告了一名 14 岁男孩，他因车祸导致左股骨颈 Delbet 1B 型骨折，股骨头骨骺部分脱离，被送往急诊室。在一次尝试闭合复位失败后，在全身麻醉下进行切开复位和后外侧 (Kocher) 入路内固定。用导针保持复位并用空心螺钉固定。经过8个月的随访，发现了AVN。我们报告了一名 14 岁男孩，他因车祸导致左股骨颈 Delbet 1B 型骨折，股骨头骨骺部分脱离，被送往急诊室。在一次尝试闭合复位失败后，在全身麻醉下进行切开复位和后外侧 (Kocher) 入路内固定。用导针保持复位并用空心螺钉固定。经过8个月的随访，发现了AVN。我们报告了一名 14 岁男孩，他因车祸导致左股骨颈 Delbet 1B 型骨折，股骨头骨骺部分脱离，被送往急诊室。在一次尝试闭合复位失败后，在全身麻醉下进行切开复位和后外侧 (Kocher) 入路内固定。用导针保持复位并用空心螺钉固定。经过8个月的随访，发现了AVN。
案例代表 Orthop Res 2022；5：24–30