Highlights the specific hazard of malunion in the coxa vara position when treating femoral neck fractures in children.
Alerts to coxa vara malunion risk despite prompt union in pediatric femoral neck fractures; leaves open optimal prevention strategies.
The problems encountered in treating a small group of young patients with fracture of the neck of the femur have demonstrated specific hazards in the management of this fracture which affect the prognosis and the ultimate functional result. Bony union takes place promptly, as is true of most fractures in childhood, there being slight danger of nonunion, a disaster so greatly feared when this fracture occurs in the aged. The unfavorable prognosis that is associated with fracture of the neck of the femur in childhood arises from the frequent occurrence of malunion in the coxa vara position. This deformity tends to increase with weight bearing and may lead to extreme disability. The reasons for the occurrence of union of the fracture in malposition may be structure of the bone at the site of fracture, muscular contraction or early weight bearing. The difference in osseous structure in youth and old age
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Joseph I. Mitchell (1936) studied this question.
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