scholarly journals An Irreducible Hip Dislocation with Femoral Head Fracture

2018 ◽  
Vol 31 (3) ◽  
pp. 181-188
Author(s):  
Tae-Seong Kim ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Kyeong-Hyeon Park
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
Femoral Head Fracture

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

scholarly journals Fractures of the femoral head: a narrative review

2021 ◽  
Vol 6 (11) ◽  
pp. 1122-1131
Author(s):  
Maximilian M. Menger ◽  
Benedikt J. Braun ◽  
Steven C. Herath ◽  
Markus A. Küper ◽  
Mika F. Rollmann ◽  
...  
Keyword(s):  
Femoral Head ◽  
Surgical Approach ◽  
Motor Vehicle ◽  
Hip Dislocation ◽  
High Energy ◽  
Femoral Head Fracture ◽  
Concomitant Injuries ◽  
Vehicle Accidents ◽  
Joint Congruity

Fractures of the femoral head are rare injuries, which typically occur after posterior hip dislocation. The Pipkin classification, developed in 1957, is the most commonly used classification scheme to date. The injury is mostly caused by high-energy trauma, such as motor vehicle accidents or falls from a significant height. Emergency treatment consists of urgent closed reduction of the hip joint, followed by non-operative or operative treatment of the femoral head fracture and any associated injuries. There is an ongoing controversy about the suitable surgical approach (anterior vs. posterior) for addressing fractures of the femoral head. Fracture location, degree of displacement, joint congruity and the presence of loose fragments, as well as concomitant injuries are crucial factors in choosing the adequate surgical approach. Long-term complications such as osteonecrosis of the femoral head, posttraumatic osteoarthritis and heterotopic ossification can lead to a relatively poor functional outcome. Cite this article: EFORT Open Rev 2021;6:1122-1131. DOI: 10.1302/2058-5241.6.210034

scholarly journals Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

2021 ◽  
Vol 22 (S2) ◽  
Author(s):  
Domenico De Mauro ◽  
Giuseppe Rovere ◽  
Amarildo Smakaj ◽  
Silvia Marino ◽  
Gianluca Ciolli ◽  
...  
Keyword(s):  
Femoral Head ◽  
Internal Fixation ◽  
Open Reduction ◽  
Case Series ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Femoral Head Fracture ◽  
Surgical Hip Dislocation ◽  
Modified Harris Hip Score

Abstract Background The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required. Case presentation Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D’Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9–100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d’Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients. Conclusions Gibson’s approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications.

scholarly journals Early versus delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation: a comparative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shanxi Wang ◽  
Bohua Li ◽  
Zhengdong Zhang ◽  
Xiaojun Yu ◽  
Qin Li ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Fracture Healing ◽  
Hip Dislocation ◽  
Healing Time ◽  
Early Group ◽  
Femoral Head Fracture ◽  
Hip Reduction ◽  
Delayed Group ◽  
Posterior Hip Dislocation

Abstract Background Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the safe interval time between injury and hip reduction remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation. Methods A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 h after injury) and delayed group (between 6 and 12 h after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation. Results The mean hospital stay and fracture healing time in the early group were significantly lower than those in the delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than that in the early group. The early group had better functional outcomes in terms of Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores and physical component scale (PCS) than the delayed group. Conclusions For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient rehabilitation, and obtain a better functional outcome.

Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

2021 ◽  
Author(s):  
Shanxi Wang ◽  
Bohua Li ◽  
Zhengdong Zhang ◽  
Xiaojun Yu ◽  
Qin Li ◽  
...  
Keyword(s):  
Femoral Head ◽  
Fracture Healing ◽  
Functional Outcomes ◽  
Hip Dislocation ◽  
Healing Time ◽  
Early Group ◽  
Femoral Head Fracture ◽  
Hip Reduction ◽  
Delayed Group ◽  
Posterior Hip Dislocation

Abstract Background: Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the the safe interval time between injury and reduction still remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in treating femoral head fracture combined with posterior hip dislocation. Methods: A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 hours after injury) and delayed group (between 6 - 12 hours after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation.Results: The mean hospital day and fracture healing time in the early group were significantly lower than delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than early group. The early group had better functional outcomes in term of Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores and physical component scale (PCS) than delayed group. Conclusions: For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient recovery as well as obtain better functional outcomes.

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