{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:39:40Z","timestamp":1773995980982,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Femoral neck fracture is a less common injury in childhood but carry a high risk of avascular necrosis (AVN) of the femoral head. This study aimed to assess the clinical efficacy of needle aspiration combined with closed reduction and internal fixation (CRIF) performed within 24\u201372\u2005h of injury for the treatment of pediatric femoral neck fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study enrolled 26 children with femoral neck fractures who underwent cannulated screw fixation using CRIF at our department between January 2010 and January 2014. Based on whether needle aspiration was performed after fixation, patients were stratified into two groups: the aspiration group (AG,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) and the non-aspiration group (NG,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915). All patients were followed for a minimum of 5 years. The primary outcomes were the effects of needle aspiration and the complication of AVN. Secondary outcomes included functional outcomes assessed using Ratliff\u2019s criteria, as well as the incidence of coxa vara and non-union. According to Ratliff\u2019s criteria, a good result was defined as a \u201csatisfactory outcome,\u201d while fair and poor results were categorized as \u201cunsatisfactory outcomes.\u201d\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 26 patients (26 hips) were evaluated, including 14 girls and 12 boys, with a mean age of 9.6\u2009\u00b1\u20092.5 years (range, 5\u201314 years). No significant differences were observed between these two groups in baseline characteristics, including gender, age, affected side, type of fracture, displacement, and time to reduction. The rate of satisfactory outcomes was 81.8% in the AG group and 66.7% in the NG group (OR\u2009=\u20092.25, CI, 0.35\u201314.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.658). AVN occurred in six cases overall, with two cases in the AG group and four in the NG group (OR=1.63, CI, 0.24\u201311.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000). Based on the Ratliff classification system for AVN, four cases were classified as grade I, one as grade II, and one as grade III. Logistic regression analysis identified reduction quality as an independent risk factor for the development of AVN (OR\u2009=\u200912.06, CI, 1.01\u2013143.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049). There was no significant difference in the incidence of other complications between these two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For children under 14 years of age with type II and III femoral neck fractures, needle aspiration combined with CRIF performed within 24\u201372\u2005h of injury did not yield a statistically significant reduction in the risk of AVN compared with primary CRIF alone. Reduction quality was confirmed as an independent risk factor for postoperative AVN in this pediatric population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1768628","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:23:57Z","timestamp":1773984237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of needle aspiration combined with closed reduction and internal fixation within 24\u201372\u2005h in the treatment of pediatric femoral neck fracture"],"prefix":"10.3389","volume":"14","author":[{"given":"Jingjing","family":"Zuo","sequence":"first","affiliation":[{"name":"Rehabilitation Medicine Centre, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueyang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s00590-021-02933-1","article-title":"The clinical features, management options and complications of paediatric femoral fractures","volume":"31","author":"Duffy","year":"2021","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1097\/BOT.0000000000001645","article-title":"Femoral neck fractures in children: issues, challenges, and solutions","volume":"33","author":"Barreto Rocha","year":"2019","journal-title":"J 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