Early versus late treatment of paediatric femoral neck fractures: a systematic review and meta-analysis

Early versus late treatment of paediatric femoral neck fractures: a systematic review and... Purpose Femoral neck fractures in children represent less than 1% of all paediatric fractures. Osteonecrosis of the femoral head is one of the devastating complications of this fracture. Time to treatment is one of the most important predictors of this outcome with no clear consensus in the literature. The aim of this study was to determine whether early treatment (< 24 hours) of pediatric femoral neck fractures is associated with a lower rate of osteonecrosis of the femoral head compared to late treatment (> 24 hours). Methods We searched several databases (PubMed, Embase, and Cochrane library), from January 1966 to November 2017 for any comparative studies that evaluated early (< 24 hours) versus late (> 24 hours) treatment of paediatric femoral neck fractures. We pooled the effect sizes using fixed effects model that compared the rate of osteonecrosis of the femoral head between children undergoing early versus late treatment, open versus closed reduction, displaced versus non-displaced and different Delbet type femoral neck fractures. Descriptive and qualitative data was also extracted. Results Of the 391 articles identified, six studies (prospective and retrospective cohort studies) were eligible for the meta- analysis, with a total of 231 paediatric femoral neck fractures. The http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Orthopaedics Springer Journals

Early versus late treatment of paediatric femoral neck fractures: a systematic review and meta-analysis

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by SICOT aisbl
Subject
Medicine & Public Health; Orthopedics
ISSN
0341-2695
eISSN
1432-5195
D.O.I.
10.1007/s00264-018-3998-4
Publisher site
See Article on Publisher Site

Abstract

Purpose Femoral neck fractures in children represent less than 1% of all paediatric fractures. Osteonecrosis of the femoral head is one of the devastating complications of this fracture. Time to treatment is one of the most important predictors of this outcome with no clear consensus in the literature. The aim of this study was to determine whether early treatment (< 24 hours) of pediatric femoral neck fractures is associated with a lower rate of osteonecrosis of the femoral head compared to late treatment (> 24 hours). Methods We searched several databases (PubMed, Embase, and Cochrane library), from January 1966 to November 2017 for any comparative studies that evaluated early (< 24 hours) versus late (> 24 hours) treatment of paediatric femoral neck fractures. We pooled the effect sizes using fixed effects model that compared the rate of osteonecrosis of the femoral head between children undergoing early versus late treatment, open versus closed reduction, displaced versus non-displaced and different Delbet type femoral neck fractures. Descriptive and qualitative data was also extracted. Results Of the 391 articles identified, six studies (prospective and retrospective cohort studies) were eligible for the meta- analysis, with a total of 231 paediatric femoral neck fractures. The

Journal

International OrthopaedicsSpringer Journals

Published: Jun 5, 2018

References

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