Introduction: Pathological femoral neck fractures are rare but significant injuries in children with osteopetrosis and pose unique management challenges. Optimal treatment strategies remain controversial, particularly in skeletally immature patients with open physes. Case Report: We report a rare case of a 6-year-old boy with osteopetrosis who sustained a pathological fracture of the left femoral neck following trivial trauma. The child was managed with closed reduction and physeal-sparing internal fixation using cannulated cancellous screws, followed by hip spica immobilization. Although fracture union was achieved, the patient subsequently developed slippage of the capital femoral epiphysis, resulting in a painless limp and limb length discrepancy. Conclusion: This case highlights the importance of fixation strategy in pathological pediatric femoral neck fractures and suggests that crossing the physis may be necessary to prevent late epiphyseal slippage. Keywords: Osteopetrosis, pediatric femoral neck fracture, pathological fracture, cannulated cancellous screws.
Reddy et al. (Thu,) studied this question.