Femoral Head Fractures Adam Starr, MD Chief, Orthopaedic Surgery - - PowerPoint PPT Presentation

Femoral Head Fractures

Adam Starr, MD Chief, Orthopaedic Surgery Parkland Memorial Hospital Professor and Executive Vice Chair Department of Orthopaedic Surgery UT Southwestern Medical Center Dallas, Texas

Many Don’t Need Treatment!

(Credit Orthobullets)

Usually Caused By Hip Dislocation +/- Posterior Wall Acetabular Fracture

(Credit Harborview)

Another One

(Credit Pinterest!)

Stability

Ball and socket joint. Ball is too small, socket is too big. You have to fix at least one.

If the head fracture is BELOW the equator – and it usually is – it’s often simplest to fix the wall.

Beneficial

Simplifies management a LOT

• f you can ignore the

antero-inferior femoral head fracture. Posterior wall repair is enough to regain stability.

Head Fracture Involves WBD?

Different story. Then you need to address the head with ORIF. Often use a Smith- Peterson approach.

Buy It if You Can Find It. Fantastic Illustrations of the Smith Peterson

My Plea

Don’t dislocate the hip unless you absolutely have to. Usually there are inferior periosteal attachments still hanging on displaced head fragments. Sometimes you have no choice. In those settings, anticipate osteochondral loss.

Traumatic Osteochondral Injury of the Femoral Head Treated by Mosaicplasty: A Report of Two Cases ResearchGate · September 2010, Nam, Buly, Shindle, Lorich

Thank You