Femoral head fracture: Difference between revisions
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*Usually occurs along with dislocation: | *Usually occurs along with dislocation: | ||
**Posterior dislocation | **Posterior dislocation | ||
***Affected leg appears shortened, internally rotated, adducted | |||
***Fx of inf aspect of femoral head; concomitant sciatic nerve injury | ***Fx of inf aspect of femoral head; concomitant sciatic nerve injury | ||
**Anterior dislocation | **Anterior dislocation | ||
***Affected leg appears shortened, externally rotated, abducted | |||
***Fx of anterior femoral head; concomitant vascular injury | ***Fx of anterior femoral head; concomitant vascular injury | ||
Revision as of 23:18, 25 February 2016
Background
Clinical Features
- Results from high-energy trauma (e.g. dashboard to flexed knee)
- Usually occurs along with dislocation:
- Posterior dislocation
- Affected leg appears shortened, internally rotated, adducted
- Fx of inf aspect of femoral head; concomitant sciatic nerve injury
- Anterior dislocation
- Affected leg appears shortened, externally rotated, abducted
- Fx of anterior femoral head; concomitant vascular injury
- Posterior dislocation
Differential Diagnosis
Femur Fracture Types
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Diagnosis
- Consider AP pelvis in addition to AP/lateral views to compare contralateral side
- Consider MRI if strong clinical suspicion but negative x-ray
Management
- Immediate ortho consult; emergent closed reduction of dislocation
Disposition
- Admit