Total Hip Arthroplasty for the Sequelae of Femoral Neck Fractures in the Pediatric Patient

Safa C. Fassihi, Ryan Mortman, Jacob Shalkevich, Danny Lee, William T. Stoll, Savyasachi Thakkar

Research output: Contribution to journalArticlepeer-review

Abstract

Although rare, total hip arthroplasty (THA) may be indicated in pediatric patients with degenerative changes of the hip joint after previous trauma. To illustrate management principles in this patient population, this study describes the case of a 15-year-old female who sustained bilateral femoral neck fractures after a generalized tonic-clonic seizure, an atypical, low-energy mechanism for this injury. These fractures were not diagnosed until 14 weeks after the seizure episode, at which point they had progressed to nonunion on the left side, malunion on the right side, and degenerative hip joint changes were developing bilaterally. Bilateral THA was ultimately performed, and the patient had favorable outcomes at 1 year postoperatively. In determining the optimal management strategy for such patients, a multidisciplinary approach should be used, with input from the patient's family, pediatrician, pediatric endocrinologist, pediatric orthopaedic surgeon, and adult reconstruction surgeon. From a surgical standpoint, this report highlights the importance of selecting the appropriate bearing surfaces, broaching technique, mode of implant fixation, and implant features when performing THA in the active pediatric patient.

Original languageEnglish (US)
Pages (from-to)296-304
Number of pages9
JournalArthroplasty Today
Volume6
Issue number3
DOIs
StatePublished - Sep 2020
Externally publishedYes

Keywords

  • Femoral neck fracture
  • Pediatric
  • Seizure
  • Total hip arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint

Dive into the research topics of 'Total Hip Arthroplasty for the Sequelae of Femoral Neck Fractures in the Pediatric Patient'. Together they form a unique fingerprint.

Cite this