Femoral head fractures are rare, usually as a result of high-energy trauma, and may be associated with hip fractures or hip dislocations.
Femoral Head Fracture
Isolated or with associated lesion (Pipkin)
They typically result from road accidents (patients without seatbelts colliding with the knee against the front panel of the car), falls from height, sports injuries or industrial accidents. The most commonly associated injuries are: a) femoral neck fracture; b) acetabular fracture; c) sciatic nerve neuropraxis; d) avascular necrosis of the femoral head (AVN); e) ligament injury and knee instability.
The cardinal symptoms are: localised pain in the hip area, inability to walk and other symptoms associated with the trauma that caused the injury. The diagnosis is made using simple hip and pelvis X-rays and computerised tomography may be necessary to confirm the injury, associated pathology, joint reduction, research of articular free bodies and classification of the type of fracture for the respective treatment.
Fractures without deviation can be treated conservatively.
Deviated fractures usually involve surgical treatment:
– small bone fragments can be removed arthroscopically;
– large bone fragments in young people can be fixed with screws;
– large bone fragments in older people involve the placement of a partial or total hip replacement.
