Femoral head injuries: Which treatment strategy can be recommended?

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

“…Similar to the literature, our series of femoral head fractures involved different fracture types and different treatment modalities. Since this trauma is rarely seen, the published series are small in number (5 patients in our series); Henle [21] reported 12 patients over an 8-year period. Therefore, making a statistical analysis or any recommendation is almost impossible.…”

“…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.…”

“…Conservative treatment is accepted only when postreduction CT demonstrates anatomical reduction. [21] Closed nonoperative treatment can be the best option for Pipkin type I and type II fractures. If closed reduction is not appropriate, ORIF should be the choice of treatment, excision of the fragments is the worst of all.…”

Anteriore Zugänge zum Acetabulum

“…[20,27]. Für Femurkopffrakturen wird jedoch vermehrt die chirurgische Hüftluxation über einen dorsalen Zugang mit Trochanterosteotomie eingesetzt [9]. Der iliofemorale Zugang kann auch mit dem modifizierten Stoppa-Zugang kombiniert werden, z.…”

Stepped Osteotomy of the Trochanter for Stable, Anatomic Refixation

“…Using this technique, the incidence of superior migration of the greater trochanter more than 1 cm has decreased to 0% averaging 1.5 mm (range, 0-8 mm) [15]. With this innovation, the application of the transtrochanteric approach has expanded from primary THA to revision hip arthroplasty [11], to fracture fixation of the acetabulum [4,16] or the femoral head [9], and to the treatment of femoroacetabular impingement [8]. However, nonunion and malunion of the trochanteric osteotomy, even in patients with good bone stock, are still not infrequent (approximately 5%) [1,7].…”