title: STUDY OF THE TREATMENT OF FEMORAL HEAD FRACTURES.
abstract: OBJECTIVE
  To establish guidelines for the treatment of femoral head fractures and to determine the best form of access in cases treated surgically.
  
  
  METHODS
  We evaluated the clinical and radiological results from 13 patients (13 fractures) treated surgically, between May 1986 and July 1996, at the Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de Sao Paulo (SCMSP), Fernandinho Simonsen Wing.
  
  
  RESULTS
  Out of six cases of Pipkin 1 fractures, five underwent resection of the fragment, resulting in four excellent and one good result. The good result had fixation of the fragment. Three patients presented Pipkin 2 fractures and all of them had fixation of the fragment, resulting in two excellent and one regular result. Two patients had Pipkin 3 fractures and underwent primary arthroplasty. Among the two patients with Pipkin 4 lesions, one was treated with reduction and osteosynthesis of the acetabular fracture, without addressing the head fragment, which had reduced significantly, resulting in early arthrosis; and the other patient was treated with total arthroplasty as the primary treatment.
  
  
  CONCLUSIONS
  Upon comparing the literature review and our patients' treatment results, we concluded that femoral head fracture treatment needs to be surgical and that the choice of surgical access depends on the type of fracture.
authors.affiliation: MSc from FCMSCSP and Lecturer; Attending physician in the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Rodrigo Pereira
authors.initials: RP
authors.lastname: Guimaraes
authors.affiliation: Orthopedist and former trainee in the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Gilliatt
authors.initials: G
authors.lastname: Saeki de Souza
authors.affiliation: PhD from FCMSCSP and Assistant Professor; Head of the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Sandro
authors.initials: S
authors.lastname: da Silva Reginaldo
authors.affiliation: PhD from FCMSCSP and Lecturer; Senior Member of the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Nelson Keiske
authors.initials: NK
authors.lastname: Ono
authors.affiliation: PhD from FCMSCSP and Assistant Professor; Attending Physician in the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Emerson Kiyoshi
authors.initials: EK
authors.lastname: Honda
authors.affiliation: Orthopedist and Attending Physician in the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Giancarlo Cavalli
authors.initials: GC
authors.lastname: Polesello
authors.affiliation: Orthopedist and Attending Physician in the Hip Group, Department of Orthopedics and Traumatology, FCMSCSP.
authors.forename: Walter
authors.initials: W
authors.lastname: Riccioli
keywords: Femoral head; Femur; Fracture consolidation; Fracture fixation