Femoral head fracture: Difference between revisions
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**Posterior dislocation | **Posterior dislocation | ||
***Affected leg appears shortened, internally rotated, adducted | ***Affected leg appears shortened, internally rotated, adducted | ||
*** | ***Fracture of inf aspect of femoral head; concomitant sciatic nerve injury | ||
**Anterior dislocation | **Anterior dislocation | ||
***Affected leg appears shortened, externally rotated, abducted | ***Affected leg appears shortened, externally rotated, abducted | ||
*** | ***Fracture of anterior femoral head; concomitant vascular injury | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 02:09, 3 July 2016
Background
Clinical Features
- Results from high-energy trauma (e.g. dashboard to flexed knee)
- Can occur with dislocation:
- Posterior dislocation
- Affected leg appears shortened, internally rotated, adducted
- Fracture of inf aspect of femoral head; concomitant sciatic nerve injury
- Anterior dislocation
- Affected leg appears shortened, externally rotated, abducted
- Fracture 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