Abstract
1. Fracture of the neck of the femur in childhood and its complications are discussed.
2. The high incidence of these complications is not generally appreciated–in this series of twenty-four patients only eight achieved normal hip joints.
3. The complications are due to the arrangement of the blood supply to the head and neck. Avascular necrosis is unavoidable in a high proportion, and is not directly related to any particular method of treatment.
4. Extreme care and gentleness in handling the injured limb will help to reduce the incidence of deformities; internal fixation is not suitable for the very young as it may predispose to necrosis or may damage the epiphysis. In older children it can be used with care.
5. Where growth is still taking place in the limb the retention of the angle between neck and shaft is most important, as this will prevent coxa vara and progressive shortening with the consequent unsightly Trendelenburg limp.
