Abstract
Purpose: Fractures of the femoral head are relatively uncommon injuries and usually occur following a traumatic dislocation of the hip joint. The purpose of this study was to evaluate self-reported functional outcome of patients who have sustained a femoral head fracture.
Methods: A search of the trauma database at a Level I trauma center between the years 1987–2003 was conducted. Sixty two patients, sustaining 63 femoral head fractures were identified. Two patient-based outcome measures, the Short Form-36 (SF-36) and Short Musculoskeletal Functional Assessment (SMFA) were used to evaluate functional outcome. Forty patients were lost to follow-up including three deaths.
Results: To date twenty-three subjects (13 male, mean age 37.3 +/− 15.6), with 24 femoral head fractures have complete functional outcome data. Ten hips (42%) were classified as Pipkin type I, 12 (50%) type II, 1 (4%) type III, and 1 (4%) type IV. The mean follow-up was 10.3 +/− 5.4 yrs. Mechanism of injury included motor vehicle collisions (18/24), and falls from height (6/24). The mean ISS was 11.3 +/− 5.3. Fifteen subjects were treated operatively (13 internal fixation, 1 excision, 1 open reduction only). Four hips failed initial treatment and required delayed total hip arthroplasty (THA). Subjects (n=20) not having a THA functioned below the Canadian normal population for SF-36 physical component score (mean 44.5 +/− 11.0, p < 0.03).
Conclusions: This is the first report of patient-based functional outcome following treatment of femoral head fractures. Physical function was significantly lower when compared to Canadian population norms.
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
