Surgical Treatment and Prognosis of Acetabular Fractures Associated with Ipsilateral Femoral Neck Fractures

Abstract

Combined ipsilateral acetabular and femoral neck fractures are the result of high-energy trauma. Satisfactory treatment for this injury pattern remains a challenge, since traditional open reduction and internal fixation (ORIF) is always accompanied by a high prevalence of posttraumatic arthritis and avascular necrosis of the femoral head. Eight of 502 acetabular fractures from 1990 to 2008 were diagnosed with combined ipsilateral femoral neck fracture, in which 5 patients' fractures were associated with hip dislocation. These patients were injured from falls, traffic accidents, or crushing accidents. Radiographs and computed tomography scans were taken to check acetabular and femoral neck fractures. All of the patients underwent surgery using appropriate approaches and techniques. Postoperative radiographs demonstrated anatomic or satisfactory reduction for acetabular fractures as well as excellent or good reduction for femoral neck fractures in all of the patients. Follow-up radiographs showed femoral head necrosis in the 5 patients with femoral head dislocations, but not in the other 3 patients. We have seen few patients with this injury pattern, which makes us unable to detect significant differences between the patients associated with femoral head dislocation and those without femoral head dislocation. But by considering the results of our study and those reported in the literature, we believe that for patients with ipsilateral acetabular and femoral neck fractures without hip dislocation, satisfactory results could be expected after ORIF. But for those cases associated with hip dislocation, alternative methods such as acute THR as primary treatment are worthy of consideration.

Influence of age on results following surgery for displaced acetabular fractures in the elderly

“…The patient-centered outcome scores for elderly patients may be much helpful. However, the modified Postel Merle D’Aubigne Score is widely applied to assess the clinical function of patients with acetabular fractures, and this scoring system has been routinely used since 1990 [ 16 , 17 ].…”

Treatment of Fracture Dislocation of the Femoral Head in a Resource Limited Country (Burundi)

“…In fact, these two patients were at high risk of avascular necrosis since their treatment was delayed beyond 12 hours. According to Li Wei [17], total hip arthroplasty is justified when the risk of necrosis is high.…”

Traumatic Posterior Hip Dislocation with an Ipsilateral Comminuted Femoral Intertrochanteric Fracture: A Case Report

“…However, we also agree with some authors that ORIF is the preferred primary treatment for this injury pattern, especially in young laborers, because the intact femoral head allows the stable placement of internal fixation devices. In addition, a subsequent total hip replacement is an effective salvage procedure after failed treatment of an intertrochanteric fracture and the development of severe post‐traumatic arthritis or avascular necrosis of femoral head.…”