Three Cases of Femoral Head Fracture in a Single Car Accident

Vermeiren, J. A. M.; Hoye, M. Van

doi:10.1097/00005373-199104000-00020

Cited by 8 publications

(8 citation statements)

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“…Excision of large fragments will cause too much stress in the hip joint to carry out its functions particularly in young active patients. We agree with this opinion, as did Vermeiren and Hoye [23]. Thus, in young individuals every effort was made to keep the detached fragment as viable as possible by meticulous handling and preservation of its synovial attachment.…”

Section: Discussionsupporting

confidence: 72%

Femoral head fractures

Mostafa

2001

International Orthopaedics (SICOT)

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This report includes six patients with femoral head fractures. Five were associated with posterior hip dislocation, of which one also had an ipsilateral trochanteric fracture. All were young adults who had been injured in automobile accidents. The protocol for management, indications for surgery and guidelines for evaluation of results are described.Résumé Présentation de 6 cas de fracture de la tête fé-morale. Cinq associaient à la fracture une luxation posté-rieure de la hanche et l'un d'eux associait aussi une fracture trochanterienne ipsilaterale. Tout les patients étaient de jeunes adultes blessés dans un accident de voiture. Le protocole de prise en charge,les indications de la chirurgie et les principes d'évaluation du résultat sont présen-tés.

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Section: Discussionsupporting

confidence: 72%

Femoral head fractures

Mostafa

2001

International Orthopaedics (SICOT)

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“…3). The average age at the time of injury was 28 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) years. Most of the fractures were due to traffic accident; only one patient sustained injury from a motor vehicle accident.…”

Section: Resultsmentioning

confidence: 99%

“…However, good or excellent results are achieved in only 50% of cases after excision of the fragments. [8,9,[11][12][13][22][23][24][25][26][27] Over the past decades, rates of excellent or good results of 40-70% have been published in the literature. [8,[22][23][24][28][29][30][31] Our rate of excellent and good results was 50%, which was similar to the literature.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Three surgical approaches are advocated in the literature: anterolateral (Watson-Jones), [22,24,32] anterior (Smith-Patterson) [24,25,31] and posterior (Kocher-Langenbeck). [26] Anterior approaches are related with high rates of heterotopic ossification, but obtain an optimal exposure of the fragments of the femoral head. [1] Swiontkowski et al [33] compared anterior versus posterior approach in the treatment of Pipkin type I and II fractures.…”

Section: Discussionmentioning

confidence: 99%

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Fractures of the femoral head: what are the reasons for poor outcome?

Özcan

Çopuroğlu²,

Sarıdoğan³

2011

Ulus Travma Acil Cerrahi Derg

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AMAÇBu yazıda, çok nadir bir yaralanma olan femur başı kırıkla-rında tedavi stratejilerinin tartışılması amaçlandı. GEREÇ VE YÖNTEMMart 2006 ile Aralık 2007 arasında acil servise femur başı kırığı ile başvuran beş hastanın altı kırığı incelendi. Cerrahi ve cerrahi dışı yöntemlerle tedavi edilen hastaların fonksiyonel sonuçları karşılaştırıldı. BULGULARHastaların yarısı cerrahi yöntemle, yarısı da cerrahi dışı yöntemlerle tedavi edildi. Mükemmel ve iyi sonuçların oranı %50 bulundu. İki taraflı yaralanması bulunan hastada avasküler nekroz gelişti. Bu hastada fonksiyonel sonuçlar kötü bulundu. Cerrahi ile tedavi edilen hastalardan birinde erken posttravmatik artrit görüldü, bu hastanın fonksiyonel sonuçları orta bulundu. SONUÇMinimum yumuşak doku travması ile anatomik redüksiyo-nun sağlanması bu kırıkların tedavisindeki amacımız olmalıdır. Parçaların en iyi görüntüsü hangi yaklaşımla sağlana-caksa o yaklaşım tercih edilmelidir. Şu unutulmamalıdır ki, tüm tedavi seçeneklerine rağmen bu hastaların fonksiyonel sonuçları kötü olabilmektedir.

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“…Over the years, a variety of surgical approaches has been advocated for the treatment of femoral head fractures, including the anterolateral (Watson-Jones) [15,21,26,28], lateral [4], medial (Ludloff) [10], anterior (Smith-Peterson) [27,26,35], and posterior (Kocher-Langenbeck) [36] approaches. Each of these approaches has advantages and disadvantages.…”

Section: Surgical Approachmentioning

confidence: 99%

Femoral Head Fractures Revisited

Kloen

Siebenrock

Raaymakers

et al. 2002

European Journal of Trauma

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Background: Femoral head fractures have long been associated with a poor outcome. To date, only a few large series have adequate follow-up, and the description of injury types, treatment and outcome are often incomplete and thereby preclude comparison. Here, we retrospectively review our results with the treatment of a large series of femoral head injuries associated with posterior hip dislocations. Patients and Methods: A retrospective review of posterior hip dislocations with femoral head fractures was done. Fractures were classified according to Pipkin, Brumback and to the AO classification. Outcome was based on physical and radiographic evaluation, in addition to the Merle d'Aubigné & Postel and the Thompson & Epstein scores. Results: 33 femoral head fractures with posterior hip dislocations were treated at our institutions between 1970 and 1999. Nonoperative treatment was chosen in seven cases, open reduction and internal fixation (ORIF) in 20, and fragment excision in six. Average follow-up was 64 months (range 24-252 months). Of these, 56% had an excellent/good result, 16% did fair, and 28% had a poor outcome. Pipkin II fractures (Brumback 2A) did better than the Pipkin I (Brumback 1A) fractures, whereas the poorest outcome was seen in the Pipkin IV (Brumback 1B and 2B) fractures. There were four presurgical nerve lesions that were sequelae of the injury. Complications included heterotopic ossification (21%), deep infection (3%), avascular necrosis (6%), and recurrent dislocation (6%). Conclusions: Posterior hip dislocations with femoral head fracture-dislocations represent severe injuries. Better visualization and ability to internally fix these fractures could potentially improve the outcome. We introduce a modified, anterolateral approach to femoral head fractures based on a digastric trochanteric osteotomy.

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Three Cases of Femoral Head Fracture in a Single Car Accident

Cited by 8 publications

References 0 publications

Femoral head fractures

Femoral head fractures

Fractures of the femoral head: what are the reasons for poor outcome?

Femoral Head Fractures Revisited

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