Risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures: a case-control study.

Case-controlHip international : the journal of clinical and experimental research on hip pathology and therapy· Aug 2026

Risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures: a case-control study.

Nirmal R Gopinathan, Akash K Ghosh, Jai P Khatri … Pebam Sudesh

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Orthopedic TraumaCase-controlPrognosisQ2IF 1.9

Greater Southwick angle after reduction is associated with avascular necrosis in Delbet type II fractures

Risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures: a case-control study.

Nirmal R Gopinathan … Pebam Sudesh

Hip international · Aug 2026 · Q2 in Orthopedics

Background

Paediatric femoral neck fractures (paediatric femoral neck fractures) are rare but carry a significant risk of avascular necrosis (avascular necrosis) of the femoral head.

Purpose

This study aimed to identify risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures and evaluate the functional outcomes following management with weight-bearing restriction and bisphosphonate therapy.

Methods

A retrospective case-control study conducted from June 2011 to May 2022 included a total of 15 Delbet type II fractures.

n = 10 patients

Results

worse reduction, higher avascular necrosis risk

OR 1.30 (95% CI 1.01 to 1.68)

CI excludes the null - significant

More results

Age >7 years and non-anatomic reduction showed high odds ratios (OR 6.00), but did not achieve statistical significance.

Reduction method, type of fixation and injury-surgery interval were not significantly associated with avascular necrosis.

More results

4 out of 5 avascular necrosis cases achieved good functional outcomes, and 1 achieved a fair outcome following a 12-month regimen of oral bisphosphonates and restricted weight-bearing.

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Conclusion · 1 of 2

An increased Southwick angle following fracture reduction is a significant predictor of avascular necrosis in Delbet type II paediatric femoral neck fractures, emphasising the critical importance of achieving anatomical reduction in the sagittal plane.

Conclusion · 2 of 2

If avascular necrosis develops, conservative management with oral bisphosphonates and protected weight-bearing yields favourable functional outcomes.

Risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures: a case-control study.

Risk factors for avascular necrosis in Delbet type II paediatric femoral neck fractures: a case-control study.

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