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Year : 2017  |  Volume : 52  |  Issue : 4  |  Page : 314-320

Clinical and radiological outcome of surgical fixation of femoral head fractures

Department of Orthopedic Surgery, Cairo University, Cairo, Egypt

Correspondence Address:
Mohamed Y Ali
Department of Orthopedic Surgery, Cairo University Hospital, Elzohor Building, El-Maadi, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_78_17

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Background Up to 16% of hip dislocations have associated femoral head fractures, but if incongruency and instability of hip occurred this is an indication for surgery; intervention could range from excision of the fractured part, fixation, or even total hip replacement. Approaches may be anterior or posterior or transtrochanteric. Except for the surgical dislocation of the hip these approaches give limited exposure; surgical dislocation gives access to 360° of the head femur. Patient and methods A retrospective study for prospectively collected data, started by 23 cases and after exclusion of those cases treated conservatively or by excision, or any intervention other than fixation, there were 12 cases left on which the study was conducted. The study was held in Cairo University Hospital on 12 patients with traumatic femoral head fracture treated surgically by reduction and fixation, between November 2012 and June 2016. Results According to Matta reduction criteria, 11 cases had anatomical reduction, one case with imperfect reduction, according to Matta radiographic criteria at follow-up, four cases with excellent score, five cases with good score, three cases with poor score, according to Merle d’ Aubigne and Postel criteria, four cases with excellent score, five cases with good score, one case with fair score, and two cases with poor score. Conclusion Surgical hip dislocation allows inspection of the entire femoral head and the full circumference of the acetabulum for rigid fixation and debridement, with low incidence of avascular necrosis, while anterior Heuter approach to the hip joint is a simple, adequate, muscle-preserving, and viable option for open reduction and internal fixation of femoral head fractures with early rehabilitation.

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