Result of Surgical Treatment for the Femoral Head Fracture

Joon Soon Kang; Kyoung Ho Moon; Tong Joo Lee; Jong Hyuck Yang

doi:10.12671/jkfs.2014.27.3.198

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Kang, Moon, Lee, and Yang: Result of Surgical Treatment for the Femoral Head Fracture

Original Article

Journal of the Korean Fracture Society 2014; 27(3): 198-205.

Published online: 16 July 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.3.198

Result of Surgical Treatment for the Femoral Head Fracture

Joon Soon Kang, M.D., Kyoung Ho Moon, M.D., Ph.D., Tong Joo Lee, M.D., Ph.D., Jong Hyuck Yang, M.D.

Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.

Address reprint requests to: Joon Soon Kang, M.D. Department of Orthopedic Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: 82-32-890-3043, Fax: 82-32-890-3047, kangjoon@inha.ac.kr

Received 8 January 2014 Revised 31 March 2014 Accepted 2 April 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Hip joint, Femur head fracture, Bony fragment excision, Open reduction and internal fixation

Figures and Tables

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.

Table 1

Details of Femoral Head Fracture

MA: Merle d'Aubigne'-Postel score, TE: Thompson-Epstein scale, HO: Heterotopic ossification, PTA: Post-traumatic arthritis, TA: Traffic accident, -: Not available, OR: Open reduction, IF: Interernal fixation, THRA: Total hip replacement arthroplasty, G: Good, P: Poor, E: Excellent, F: Fair.

Notes

Financial support: This research was supported by grant from the Inha University.

Conflict of interest: None.

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