[Femur head dislocation fractures. Long-term outcome of conservative and surgical therapy].
From 1974 to 1989, we treated 32 patients with a femoral head fracture: 28 were associated with a traumatic posterosuperior dislocation of the hip (6 Pipkin type I, 7 type II, 4 type III and 11 type IV), 1 with a posteroinferior and 3 with an anterior displacement of the femoral head. Twenty-four patients had been involved in a traffic accident, 23 had associated injuries, and the average polytrauma score (PTS) was 21. All dislocations primarily treated at our hospital were reduced by closed methods within 4 h (mean 105 min). Eleven patients received no further operative treatment, 21 were treated by open reduction and screw fixation of the fragment of the head (n = 7), fixation of the acetabular fracture (n = 3) or removal of the fragments of the head (n = 10). Four Pipkin type III fractures received primary total hip replacement. Twenty-six of the surviving 29 patients were reviewed after an average follow-up of 5 years (2-11). Radiological signs of mild arthrosis were seen in 4, moderate degeneration in 2. Partial avascular necrosis was found in 4, subchondral collapse in 1 and heterotopic ossification in 8 patients. According to the Thompson and Epstein criteria 15 of 26 patients presented fair to poor results.
Dreinhöfer
K E
KE
Orthopädische Abteilung im Rehabilitationskrankenhaus, Orthopädische Klinik der Universität Ulm.
Schwarzkopf
S R
SR
Haas
N P
NP
Tscherne
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D002648:Child; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography
Femurkopfluxationsfrakturen. Langzeitergebnisse der konservativen und operativen Therapie.