title: Traumatic ceramic femoral head fracture: an initial misdiagnosis.
abstract: OBJECTIVE
  Ceramic heads are widely used in modern total hip arthroplasty (THA). Although a rare complication, fractures of ceramic heads are described in the literature, evoking uncertainties regarding the in vivo stability of this material, especially when impaction of a fractured ceramic head can lead to disastrous results.
  
  
  METHODS
  In this case report, we present a fracture of a ceramic head after trauma. A misinterpretation of the initial radiographs led to severe fragmentation of the ceramic head two weeks after the incident, later resulting in complete destruction of the arthroplasty.
  
  
  CONCLUSIONS
  Remarkably, radiographs obtained more than one year after the trauma led to this delayed diagnosis. A single radiographic evaluation, especially in patients with persistent pain after major trauma, with a ceramic head in a THA, seems to be insufficient.
authors.affiliation: Orthopaedic Department, Helios ENDO-Klinik Hamburg, Germany.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Fard-Aghaie
authors.forename: Mustafa
authors.initials: M
authors.lastname: Citak
authors.forename: Joao
authors.initials: J
authors.lastname: Correia
authors.forename: Carl
authors.initials: C
authors.lastname: Haasper
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gehrke
authors.forename: Daniel
authors.initials: D
authors.lastname: Kendoff