Open reduction and cementation for femoral head fracture secondary to avascular necrosis: preliminary report.
Current treatment for femoral head avascular necrosis has shown good results in early stages of disease, but are not as impressive after progression to collapse. We treated 19 patients (20 hips) with Stage III avascular necrosis (AVN) by open reduction augmented by methylmethacrylate cementation. Follow up ranges from 6 months to 2 years (average = 8.7 months). We followed patient progress with pre- and post-operative Harris Hip Scores, Womac Osteoarthritis Index and a Health Status Questionnaire (SF36). All patients realized immediate post-operative pain relief and improvement in function. Harris Hip, Womac Osteoarthritis Index and SF36 physical health scores improved significantly from 54.0 to 79.5 (p < 0.05), 54.3 to 29.8 (p < 0.05) and 28.4 to 42.4 (p < 0.05), respectively. Three patients had a conversion to total hip arthroplasty. Cementation is technically simple, burns no bridges and enables patients a rapid recovery. The long term results, in regards to progression of disease and secondary arthritis, are unknown.
Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill 27599-7055, USA.
M L
ML
Wood
C M
CM
McDowell
T L
TL
Kerstetter
S S
SS
Kelley
D000203:Activities of Daily Living; D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005270:Femur Head / Q000293:injuries*; D005271:Femur Head Necrosis / Q000150:complications*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006304:Health Status; D006620:Hip Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D020366:Methylmethacrylate / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011859:Radiography; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D001843:Bone Cements; D020366:Methylmethacrylate