Is follow-up still needed after healing?

Yes. Follow-up is important to monitor femoral head viability, hip growth, limb length, and potential late complications.

Urgent Fixation of a Displaced Femoral Neck Fracture in a 10-Year-Old Girl

$Displaced pediatric femoral neck fracture fixed with cannulated screws$

A 10-year-old girl presented after trauma with a displaced femoral neck fracture. Although the injury occurred during Eid al-Adha, the case required urgent assessment and surgical management because pediatric femoral neck fractures involve a sensitive anatomical region close to the blood supply of the femoral head.

Case typeDisplaced pediatric femoral neck fracture

Age / sex10-year-old girl

DiagnosisDisplaced femoral neck fracture

Preoperative assessmentPlain radiographs and 3D CT reconstruction

TreatmentReduction and cannulated screw fixation under fluoroscopic guidance

Follow-upImmediate postoperative imaging and 6-month radiographic follow-up

Why Pediatric Femoral Neck Fractures Require Careful Management

The femoral neck is close to the femoral head and its vascular supply. For that reason, displaced femoral neck fractures in children are not treated as simple fractures. Delayed or inadequate reduction may increase the risk of loss of reduction, nonunion, coxa vara, or femoral head complications.

The main objective is to restore anatomical alignment and provide stable fixation while preserving the hip joint as much as possible, with structured follow-up after surgery.

Surgical Management

Fracture evaluation using plain radiographs and 3D CT reconstruction to define the displacement pattern and plan fixation.
Reduction of the femoral neck fracture under imaging control in the operating room.
Internal fixation using multiple cannulated screws with fluoroscopic confirmation in more than one view.
Individualized postoperative weight-bearing and follow-up according to fixation stability and radiographic healing.

Follow-Up Result

Immediate postoperative radiographs showed acceptable screw position and stable fixation. At the 6-month follow-up, the radiographs showed maintained fixation with a reassuring appearance regarding alignment and healing in the available images.

Long-term follow-up remains important in pediatric femoral neck fractures to monitor hip development, femoral head viability, limb length, and potential late complications.

Radiographic Documentation

The following images are de-identified and watermarked for educational case-library use.

Preoperative lateral radiograph showing displaced pediatric femoral neck fracture — Figure 1. Preoperative lateral radiograph showing the displaced femoral neck fracture.

Preoperative AP pelvis radiograph showing femoral neck fracture in a child — Figure 2. Preoperative AP pelvis radiograph used to assess fracture position and displacement.

3D CT anterior reconstruction of pediatric femoral neck fracture — Figure 3. 3D CT reconstruction, anterior view, used for surgical planning.

3D CT posterior reconstruction of pediatric femoral neck fracture — Figure 4. 3D CT reconstruction, posterior view, showing the fracture pattern.

Intraoperative AP fluoroscopy during cannulated screw fixation of pediatric femoral neck fracture — Figure 5. Intraoperative AP fluoroscopy confirming reduction and screw placement.

Intraoperative lateral fluoroscopy during cannulated screw fixation of pediatric femoral neck fracture — Figure 6. Intraoperative lateral fluoroscopy during cannulated screw fixation.

Immediate postoperative radiographs after cannulated screw fixation of femoral neck fracture — Figure 7. Immediate postoperative AP and lateral radiographs showing screw position and stable fixation.

Six-month follow-up radiographs after pediatric femoral neck fracture fixation — Figure 8. Six-month follow-up radiographs showing maintained fixation and reassuring alignment in the available views.

Patient-Facing Summary

A femoral neck fracture in a child is uncommon but clinically important. Successful management depends on rapid evaluation, accurate reduction, stable fixation, and structured follow-up after surgery. This case demonstrates the importance of timely surgical decision-making when a pediatric hip fracture is displaced and anatomically sensitive.

Patient FAQ

Is a femoral neck fracture in a child serious?

Yes. It is an uncommon but important injury because the fracture is close to the femoral head and its blood supply. Displaced fractures should be assessed urgently by a specialist.

Why were cannulated screws used?

Cannulated screws allow accurate fixation under fluoroscopic guidance and can provide stable fixation in selected pediatric femoral neck fractures.

Is follow-up still needed after the fracture heals?

Yes. Follow-up is important to monitor the femoral head, hip growth, limb length, and any late complications.

When can full weight-bearing start?

Weight-bearing depends on the fracture type, fixation stability, and radiographic healing. The timing should be individualized rather than generalized.

Medical note: This case is shared after removing patient-identifying information for educational purposes. It does not replace direct clinical assessment, radiographic review, or consultation with an orthopedic specialist. Any identifiable clinical photograph should only be published with written guardian consent and appropriate facial anonymization.

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