Clinical efficacy of needle aspiration combined with closed reduction and internal fixation within 24-72 h in the treatment of pediatric femoral neck fracture.

Background: Femoral neck fracture is a less common injury in childhood but carry a high risk of avascular necrosis (AVN) of the femoral head. This study aimed to assess the clinical efficacy of needle aspiration combined with closed reduction and internal fixation (CRIF) performed within 24-72 h of injury for the treatment of pediatric femoral neck fractures. Methods: This retrospective study enrolled 26 children with femoral neck fractures who underwent cannulated screw fixation using CRIF at our department between January 2010 and January 2014. Based on whether needle aspiration was performed after fixation, patients were stratified into two groups: the aspiration group (AG, Results: A total of 26 patients (26 hips) were evaluated, including 14 girls and 12 boys, with a mean age of 9.6 ± 2.5 years (range, 5-14 years). No significant differences were observed between these two groups in baseline characteristics, including gender, age, affected side, type of fracture, displacement, and time to reduction. The rate of satisfactory outcomes was 81.8% in the AG group and 66.7% in the NG group (OR = 2.25, CI, 0.35-14.61, Conclusions: For children under 14 years of age with type II and III femoral neck fractures, needle aspiration combined with CRIF performed within 24-72 h of injury did not yield a statistically significant reduction in the risk of AVN compared with primary CRIF alone. Reduction quality was confirmed as an independent risk factor for postoperative AVN in this pediatric population.