A novel direct anterior approach for the treatment of pediatric femoral neck fractures

A novel direct anterior approach for the treatment of pediatric femoral neck fractures | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A novel direct anterior approach for the treatment of pediatric femoral neck fractures Jian Zheng, Yanting Zhang, Guoxin Nan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6867389/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose The most common treatment method for femoral neck fractures (FNFs) has been closed reduction and fixation, although open reduction is sometimes inevitable. This research introduces a new direct anterior approach (DAA) for the treatment of FNFs, aiming to establish its feasibility for FNF reduction. Methods A retrospective study was performed on 24 patients (25 sides) with FNFs treated with open reduction from February 2017 to January 2023 in hospital. The patients comprised 17 males and 7 females, with 4 of them having type I fractures, 15 (16 sides) having type II fractures, and 5 having type III fractures. The patients were divided by surgical approach: Group A (Smith–Peterson/Watson–Jones), Group B (DAA). Postoperatively, a hip spica cast or plaster immobilization was applied and removed after six weeks. Weight-bearing on the affected side was avoided for three months after surgery, and internal fixation was removed six months after surgery. An MRI was then performed to examine for avascular necrosis (AVN) of the femoral head. Results Significant differences were observed in the incision length, operation time, and blood loss between Group A and B. All 24 patients were followed up for 6–36 months, with good hip joint function reported. In Group A, three patients experienced femoral head necrosis, resulting in a higher incidence of femoral head necrosis compared to Group B. Conclusions The DAA approach can be adopted for pediatric patients with FNF who require open reduction. Level of Evidence III pediatric femoral neck fracture Delbet direct anterior approach (DAA) novel approach Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6867389","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":471333719,"identity":"9b4610a2-946b-4d8f-af58-ef9fdd92e50a","order_by":0,"name":"Jian Zheng","email":"","orcid":"","institution":"Dongguan Children’s Hospital Affilated to Guangdong Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jian","middleName":"","lastName":"Zheng","suffix":""},{"id":471333720,"identity":"1885558d-9405-4e60-8e77-c2fac03d86dd","order_by":1,"name":"Yanting Zhang","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yanting","middleName":"","lastName":"Zhang","suffix":""},{"id":471333721,"identity":"cb8fdeab-2380-479d-ab34-989abdb9072b","order_by":2,"name":"Guoxin Nan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIie3QIQvCQBTA8TcGswytB4r7Cm8MxLDgRzmLSwPj4kS4FT+AyU9gNr9jdbA60GBaHlgWhnjN6LMJ3j8cF96P4x6AzfaDIQFQh8+5NyqIR5YEjj5uKRr7leSRmMAt/Y7WJ7FCJqnPSD7eEiVAQp9dPpNF00oS2KZquiPnUF05pCRCdFM1I+k6ikGiRuck0U08YU4WCes9mWdK+QVpPKlz3ITKLFmz/oJ1FT2GIQ6CotD3PmMQEPJ9J8a8acKcs9lstj/uBXd7SGfmyMxjAAAAAElFTkSuQmCC","orcid":"","institution":"Dongguan Children’s Hospital Affilated to Guangdong Medical University","correspondingAuthor":true,"prefix":"","firstName":"Guoxin","middleName":"","lastName":"Nan","suffix":""}],"badges":[],"createdAt":"2025-06-11 03:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6867389/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6867389/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85101669,"identity":"d4243b31-e803-4da6-942d-342f84aad318","added_by":"auto","created_at":"2025-06-21 07:01:45","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":598029,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6867389/v1_covered_139bc4ac-b5fe-4e81-ac0d-12dc86827dff.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A novel direct anterior approach for the treatment of pediatric femoral neck fractures","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"pediatric, femoral neck fracture, Delbet, direct anterior approach (DAA), novel approach","lastPublishedDoi":"10.21203/rs.3.rs-6867389/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6867389/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe most common treatment method for femoral neck fractures (FNFs) has been closed reduction and fixation, although open reduction is sometimes inevitable. 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An MRI was then performed to examine for avascular necrosis (AVN) of the femoral head.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant differences were observed in the incision length, operation time, and blood loss between Group A and B. All 24 patients were followed up for 6–36 months, with good hip joint function reported. 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