Atypical Localization of Calcific Shoulder Tendinopathy: Humeral Insertion of the Pectoralis Major.

INTRODUCTION

Femoral neck fractures are less frequent in adolescents. A neglected femoral neck fracture is one in which there has been a delay of more than 30 days from seeking medical attention from the time of injury [1]. The main complications are non-union and avascular necrosis (AVN) of femoral head. Various methods have been tried to successfully manage neglected femoral fractures.

CASE REPORT: A 16-year-old boy presented with complains of pain over the right hip and inability to walk for the past 3 months, following a history of fall from a height of around 6 ft. He underwent native splinting from an indigenous native bone setter for 3 months. The splint was removed after 3 months, but the symptoms did not subside. He was diagnosed to have neglected femoral neck fracture and underwent open reduction and internal fixation with three 6.5 mm cannulated cancellous screws with washers. There were no post-operative complications. The patient recovered well. At 15 months follow-up, no clinical or radiological signs of AVN were observed with excellent functional outcome.

CONCLUSION

The incidence of neglected femoral neck fractures is declining with improving health-care facilities in developing countries like India. Accurate anatomical reduction and internal fixation are important to reduce the incidence of AVN and non-union after a femoral neck fracture. Internal fixation of the fracture following valgus osteotomy is the most quoted technique in the literature.