[Avascular femur head necrosis as severe complication after femoral intramedullary nailing in children and adolescents]. Review uri icon

Overview

abstract

  • Nailing of femoral fractures before closure of the growth plates may lead to avascular necrosis of the femoral head in 3-4% of cases. In addition to the 14 cases described in the literature we present 3 more. Analysis of these cases reveals a common pathogenesis. The nails were all inserted anterograde and were designed for the adult femur. The problem appears to be related to the large diameter of the nail and its entry point in the relatively small femoral neck basis, close to the vessels supplying the femoral head. The role of the open physis remains unclear. Even though the complication of femoral head necrosis is rare, it is a severe complication. Therefore we do not recommend anterograde femoral nailing, using the classic entry point, in children or adolescents. We believe that there is a need for a new design of femoral nail. If both femoral head necrosis and coxa valga are to be avoided, we suggest that the entry point of the nail should be dorsolateral, below the trochanteric physis.

publication date

  • June 1, 1998

Research

keywords

  • Athletic Injuries
  • Femoral Fractures
  • Femur Head Necrosis
  • Fracture Fixation, Intramedullary
  • Postoperative Complications
  • Skiing
  • Soccer

Identity

Scopus Document Identifier

  • 0032087602

Digital Object Identifier (DOI)

  • 10.1007/s001130050301

PubMed ID

  • 9677850

Additional Document Info

volume

  • 101

issue

  • 6