title: New surgical algorithm for femoral head split fractures with anatomical study.
abstract: BACKGROUND
  The femoral head split fracture line is usually located in the anterior-inferior portion of the head. Proper fixation is difficult using the conventional approach without tenotomy, and thus, the authors sought to devise an effective, safe, fixation approach for the most common type of head fracture.
  
  
  METHODS
  Anatomical dissection of 80 femoral triangles was performed. The authors evaluated the locations of femoral nerves, vessels, and branches within femoral triangles. On the basis of these observations we used a new anterior approach via the non-dangerous lateral space of the femoral triangle. This approach was applied to 12 femoral head split fractures treated from 2002 to 2009.
  
  
  RESULTS
  A safe area was found within the femoral triangle at the proximal 17.5-32.5 % of the full length of the rectus femoris. In Brumback type 1A and 2A cases, screws were inserted at right angles relative to the fracture plane through the space.
  
  
  CONCLUSIONS
  This study contributes by providing a new technique for femoral head split fractures. This anterior approach using the lateral aspect of femoral triangle provided excellent and good results for Brumback type 1A and 2A femoral head split fractures. On the basis of this study, we produced new treatment algorithm for femoral head split fracture.
authors.affiliation: Department of Orthopedic Surgery, Ajou University School of Medicine, San 5 Wonchon-dong, Youngtong-gu, Suwon, Kyounggi-do 443-721, Korea. ostrauma@hanmail.net
authors.forename: Hyung Keun
authors.initials: HK
authors.lastname: Song
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Cho
authors.forename: Yu Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Do Young
authors.initials: DY
authors.lastname: Park
authors.forename: Keung Jin
authors.initials: KJ
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001863:Bone Screws; D015331:Cohort Studies; D004210:Dissection; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome