J Korean Fract Soc.  2014 Jul;27(3):198-205. 10.12671/jkfs.2014.27.3.198.

Result of Surgical Treatment for the Femoral Head Fracture

• Kang JS
• Moon KH
• Lee TJ
• Yang JH

• KMID: 1708712
• DOI: http://doi.org/10.12671/jkfs.2014.27.3.198

Abstract

PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

Keyword

Hip joint; Femur head fracture; Bony fragment excision; Open reduction and internal fixation

MeSH Terms

Acetabulum
Classification
Follow-Up Studies
Head*
Hip Joint
Humans
Retrospective Studies

Figure

• 

  Fig. 1 A 36-year-old male patient who initially underwent excision for femoral head fracture and internal fixation for femoral shaft fracture. After 94 months of trauma, total hip arthroplasty was performed due to traumatic osteoarthritis and avascular necrosis of the femoral head. (A) Immediate X-ray and computed tomography after trauma. (B) X-ray after bony fragment excision. (C) At 93 months after initial surgery, the femoral shaft fracture was well united. Heterotopic ossification, arthritis, and avascular necrosis developed. (D) Total hip arthroplasty was performed.

• 

  Fig. 2 A 49-year-old female patient who initially underwent open reduction and internal fixation of a femoral head fracture. (A) Immediate X-ray and computed tomography after trauma. (B) X-ray after closed reduction. (C) X-ray after open reduction and internal fixation using an acutrak device. (D) Thirty-one months after open reduction and internal fixation, showing no radiologic complications.

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