Module 19, General Orthopaedist Level

1, 2, 3

This 12 year old girl sustained the right femoral neck fracture by falling from a balcony. After bed-rest for 2 weeks, she was started walking with crutches. She completely returned to normal activities 6 months after the trauma. She was beginning to complain of the right hip pain 2 years after the trauma(image 2 & 3).

Question 19A

This is typical avascular necrosis (AVN) which occurs following this type of fracture in femoral neck fractures of children.

Question 19B

This AVN should now be treated similar to how one would treat a child with Perthe's disease.

Question 19C

Doing a core decompression and bone grafting is the best method for addressing this problem.

Question 19D

In this patient and the best salvage procedure if she continues to collapse and develops severe pain is a total hip replacement.

Question 19E

Another option for treating this girl at this time would be a Sugioka osteotomy.

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