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Journal of Long-Term Effects of Medical Implants
SJR: 0.133 SNIP: 0.491 CiteScore™: 0.89

ISSN Imprimir: 1050-6934
ISSN On-line: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2019031253
pages 91-99

Pathological Hip Fractures in Children and Adolescents Due to Benign Tumor or Tumor-Like Lesions

Georgios Vynichakis
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Stavros Angelis
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece; Orthopaedic and Trauma Department, Hellenic Red Cross Hospital, Athens, Greece
Michail Chandrinos
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Alexandros P. Apostolopoulos
Orthopaedic and Trauma Department, Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
Elefterios Bogris
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Hristos Mirtsios
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Petros Papapostolou
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Athanasios Kasiaras
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece
Dimitrios Filippou
Anatomy and Surgical Laboratory, Medical School of National and Kapodistrian University of Athens, Greece
John Ν.  Michelarakis
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece

RESUMO

Hip fractures are uncommon in childhood and adolescence. A high-energy injury is the most common cause. Low-energy trauma may result in a pathological hip fracture or stress fracture of the femoral neck, on the grounds of a preexisting skeletal disease, a tumor, or a tumor-like lesion. Surgical or conservative treatment may be provided based on underlying disease and/or age, Delbet and/or Colona classification, and displacement of the fracture. We present a case series of 13 children with pathological hip fracture. Mean age of patients was 7 years, and average follow-up was 3 years. There were types I and II, 3 type III, and 10 type IV fractures according to Delbet/Colona classification. Patients were treated conservatively, by open reduction and internal fixation or by minimally invasive surgery. In 11 children (84.5%), the outcome was satisfactory; one child (7.75%) presented with nonunion and refracture after minimally invasive surgery, and another (7.75%) presented with refracture after conservative treatment. Both patients were treated with open reduction and internal fixation. Pathological hip fractures are rare in children and should be treated properly. Surgical treatment with open reduction, internal fixation, and bone grafting is preferred in displaced fractures. In nondisplaced fractures, the choice between conservative and surgical treatment should be based on Delbet/Colona classification and patient profile.

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