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Neck of femur (NOF) fractures - Fracture clinics
Neck of femur (NOF) fractures are uncommon in children but can have serious consequences. They are generally a result from higher energy trauma.
Prompt orthopedic treatment is required.
2. How are they classified?
These fractures can be classified by the Delbet classification (Table 1).
Table 1: Delbet classification of neck of femur fractures.
Fracture goes through the physis (transphyseal)
Fracture goes through the middle of the femoral neck (transcervical)
Fracture goes through base of the femoral neck (cervicotrochanteric)
Fracture goes between the greater and lesser trochanters (intertrochanteric)
These fractures are rare and account for less than 1% of all paediatric fractures. They generally occur from high energy injury mechanisms (such as a fall from a height or motor vehicle collision). Pathologic fractures can occur from lower energy injuries.
All NOF fractures require prompt orthopedic assessment.
Patients involved in high energy trauma, should be assessed by Advanced Trauma Life Support (ATLS) principles. Assessment should be made to identify the presence of any other injuries. Analgesia should be given. Prompt orthopedic consultation should be made.
Any follow-up should be arranged by the orthopaedic service.
The child will be admitted to the hospital for treatment of the injury by orthopaedics.