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Original Article Risk Factors Affecting the Early Complications of Femoral Head Fractures
HoeJeong Chung, Jin-Woo Lee, Dong Woo Lee, Hoon-Sang Sohn
Journal of Musculoskeletal Trauma 2020;33(4):204-209.
DOI: https://doi.org/10.12671/jkfs.2020.33.4.204
Published online: October 31, 2020
1Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju, Korea
2Department of Orthopaedic Surgery, Hanil General Hospital, Seoul, Korea

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Abstract

Purpose
This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications.
Materials and Methods
A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren– Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher’s exact test and continuous variables using a Mann–Whitney U test.
Results
Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups.
Conclusion
The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.


J Korean Fract Soc. 2020 Oct;33(4):204-209. Korean.
Published online Oct 22, 2020.
https://doi.org/10.12671/jkfs.2020.33.4.204
Copyright © 2020 The Korean Fracture Society. All rights reserved.
Original Article

Risk Factors Affecting the Early Complications of Femoral Head Fractures

HoeJeong Chung, M.D., Jin-Woo Lee, M.D., Dong Woo Lee, M.D. and Hoon-Sang Sohn, M.D.
    • Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju, Korea.
    • *Department of Orthopaedic Surgery, Hanil General Hospital, Seoul, Korea.
  • Correspondence to: Hoon-Sang Sohn, M.D. Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju 26426, Korea. Tel: +82-33-741-0607, Fax: +82-33-741-1365, Email: traumasohn@gmail.com
Received March 12, 2020; Revised March 29, 2020; Accepted August 04, 2020.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications.

Materials and Methods

A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren–Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher's exact test and continuous variables using a Mann–Whitney U test.

Results

Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups.

Conclusion

The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.

Keywords
Fracture, Femur head, Hip dislocation, Pipkin classification, Prognosis

Figures

Fig. 1
(A) A 63-year-old male sustained Pipkin type IV fracture of the left hip with a dislocation. (B) Closed reduction was performed immediately in the emergency room. (C) Open reduction and internal fixation with headless compression screws using surgical hip dislocation were performed. (D) Good clinical and radiographic outcomes were obtained in the last follow up (postoperative 12 months).

Fig. 2
(A) A 31-year-old male sustained Pipkin type IV fracture of the right hip. (B) Bone and cartilage loss were observed in the weight-bearing portion of the femoral head. (C) Transpositional osteoplasty with an allofibula bone graft was performed. (D) Coronal view of the postoperative computed tomography scan.

Fig. 3
(A) A 47-year-old female sustained Pipkin type IV fracture of the right hip. (B) Open reduction and internal fixation using surgical hip dislocation were performed. (C) Femoral head collapse and screw exposure were observed at postoperative six months. (D) Total hip arthroplasty was performed.

Tables

Table 1
Demographics of Patients

Table 2
Comparison between Early Complications Group and Non-Complications Group

Table 3
Comparison between Early Complications Group and Non-Complication Group

Notes

Financial support:None.

Conflict of interests:None.

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    Risk Factors Affecting the Early Complications of Femoral Head Fractures
    J Korean Fract Soc. 2020;33(4):204-209.   Published online October 31, 2020
    DOI: https://doi.org/10.12671/jkfs.2020.33.4.204
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