The treatment of displaced femoral neck fractures with vascularized great trochanter periosteal flap transposition in children.

Abstract

In this study, we investigated the clinical outcome of the treatment of displaced femoral neck fractures with vascularized great trochanter periosteal flap transposition in children. There were 23 children with displaced femoral neck fractures. Using Delbet classification, there were 2 type I (transepiphyseal), 12 type II (transcervical), and 9 type III (cervicotrochanteric). All the treatments were carried out with vascularized great trochanter periosteal flap transposition, and fixed by Kirschner needle or hollow screws. Both methods achieved healing and patients were followed from 9 months to 5 years, with average follow-up of 3 years. Avascular necrosis (AVN) of the femoral head occurred in three children; early closure of epiphysis occurred in one child; and restricted movement was seen in three children. According to Ratliff function assessment and Harris hip score, the results were: 17 excellent, 3 good, and 3 poor. The excellent and good rates reached 87.1%. The vascularized greater trochanter periosteal flap transposition may accelerate the union of fractures, improve blood supply to the femoral head, and reduce the incidence rate of AVN. This flap is therefore an effective method for the treatment of displaced femoral neck fractures in children.