Intravenous Bisphosphonate Therapy for Children Who Have a Traumatic Fracture Neck of Femur and Osteonecrosis: A Case Report
Satapong Pisuitthanakan MD*, Teerapon Premprabha MD**
Affiliation : * Department of Orthopedics, Hatyai Hospital Center, Hat Yai, Songkhla, Thailand ** Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Background : Prognosis of traumatic osteonecrosis of femoral head in children is poor for either conservative treatment or
surgical intervention. Intravenous bisphosphonate is an expecting medication to reduce femoral head resorption and to
prevent femoral head collapse after traumatic osteonecrosis. This mechanism will reduce development of osteoarthritis and
disability in the future.
Objective : Report the result of the effectiveness of intravenous bisphosphonate in treatment of a child with traumatic fracture
neck of femur and developed osteonecrosis.
Material and Method: A case report was done between May 2008 and June 2010. The patient developed traumatic osteonecrosis
of the right femoral head after multiple screws fixation in treatment of femoral neck fracture. Intravenous bisphosphonate was
given every other month for two years.
Results : A 13-year-old girl who had a motorcycle accident developed avascular necrosis after multiple screws fixation of
femoral neck fracture. After an intravenous bisphosphonate was given every other month for two years, the last follow-up
showed good prognosis.
Keywords : Traumatic osteonecrosis in children, Intravenous bisphosphonate, Femoral head resorption, Avascular necrosis, Fracture neck of femur
