Transphyseal Femoral Neck Fracture in a Twenty-Month Old Male Child

Matthew J. Brown*, Michael R. Ferrick
Department of Orthopaedics, State University of New York at Buffalo, 462 Grider St., Buffalo, NY 14215, USA

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© Brown and Ferrick; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this authors at the Department of Orthopaedics, State University of New York at Buffalo, 462 Grider St., Buffalo, NY 14215, USA; Tel: 314-541-4144; Fax: 716-898-3323; E-mail:


Transphyseal femoral neck fractures are an extremely rare event, mainly occurring in children subjected to an significant traumatic force. The diagnosis is usually suggested by clinical examination with radiographic confirmation. Management varies; however, no consensus exists as to proper treatment. Intervention is primarily focused on the prevention of avascular necrosis (AVN) of the femoral epiphysis.

We present the case of a 20-month-old male with a delayed diagnosis of transphyseal femoral neck fracture. X-ray (XR) and computed tomography (CT) scan images were used for diagnosis, to track healing, and monitor the possible emergence of avascular necrosis. Final imaging demonstrated full healing without AVN at two years.

This study demonstrates the successful treatment of a rare pediatric fracture type with possible life-changing complications. Reduction, surgical fixation with K-wires, and spica casting are demonstrated as being acceptable treatment in the very young transphyseal fracture patient.

Keywords: Transphyseal femoral neck fracture, avascular necrosis.