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Femoral Head Fracture
MK Jesse, MD; Kirkland W. Davis, MD, FACR; Julia R. Crim, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Subchondral fracture of femoral head
            • Osteochondral fracture of hip
            • Capital fracture
          • Definitions

            • Fracture of head of femur, displaced or nondisplaced
            • Distinguished from femoral neck fracture
            • Occurs due to
              • Posterior dislocation of hip
              • Axial loading trauma
              • Atypical twisting injury at hip

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Scolaro JA et al: Management and radiographic outcomes of femoral head fractures. J Orthop Traumatol. 18(3):235-41, 2017
                                          2. Sheehan SE et al: Proximal femoral fractures: what the orthopedic surgeon wants to know. Radiographics. 35(5):1563-84, 2015
                                          3. Chiron P et al: Fracture-dislocations of the femoral head. Orthop Traumatol Surg Res. 99(1 Suppl):S53-66, 2013
                                          4. Gao YS et al: Injury-to-surgery interval does not affect postfracture osteonecrosis of the femoral head in young adults: a systematic review. Eur J Orthop Surg Traumatol. 23(2):203-9, 2013
                                          5. Ikemura S et al: Subchondral insufficiency fracture of the femoral head: a report of two cases with a history of internal fixation of a femoral neck fracture. Skeletal Radiol. 42(6):849-51, 2013
                                          6. Kosashvili Y et al: Fresh-stored osteochondral allografts for the treatment of femoral head defects: surgical technique and preliminary results. Int Orthop. 37(6):1001-6, 2013
                                          7. Kokubo Y et al: Dislocated intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum: report of 12 cases and technical notes on surgical intervention. Eur J Orthop Surg Traumatol. 23(5):557-64, 2012
                                          8. Clegg TE et al: Hip dislocations--epidemiology, treatment, and outcomes. Injury. 41(4):329-34, 2010
                                          9. Nousiainen MT et al: The use osteochondral allograft in the treatment of a severe femoral head fracture. J Orthop Trauma. 24(2):120-4, 2010
                                          10. Giannoudis PV et al: Management, complications and clinical results of femoral head fractures. Injury. 40(12):1245-51, 2009
                                          11. Iwasaki K et al: Subchondral insufficiency fracture of the femoral head after liver transplantation. Skeletal Radiol. 38(9):925-8, 2009
                                          12. Lee YK et al: Collapsed subchondral fatigue fracture of the femoral head. Orthop Clin North Am. 40(2):259-65, 2009
                                          13. Matsuda DK: A rare fracture, an even rarer treatment: the arthroscopic reduction and internal fixation of an isolated femoral head fracture. Arthroscopy. 25(4):408-12, 2009
                                          14. Yeh LR et al: Diagnostic performance of MR imaging in the assessment of subchondral fractures in avascular necrosis of the femoral head. Skeletal Radiol. 38(6):559-64, 2009
                                          15. Cabarrus MC et al: MRI and CT of insufficiency fractures of the pelvis and the proximal femur. AJR Am J Roentgenol. 191(4):995-1001, 2008
                                          16. Sudo A et al: Bilateral subchondral insufficiency fracture of the femoral head. Orthopedics. 31(4):399, 2008
                                          17. Yamamoto T et al: Subchondral insufficiency fracture of the femoral head in younger adults. Skeletal Radiol. 2006
                                          18. Asghar FA et al: Femoral head fractures: diagnosis, management, and complications. Orthop Clin North Am. 35(4):463-72, 2004
                                          19. Khanna AJ et al: Rapidly destructive osteoarthropathy of the hip. Am J Orthop. 33(5):243-7, 2004
                                          20. Song WS et al: Subchondral fatigue fracture of the femoral head in military recruits. J Bone Joint Surg Am. 86-A(9):1917-24, 2004
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Subchondral fracture of femoral head
                                                    • Osteochondral fracture of hip
                                                    • Capital fracture
                                                  • Definitions

                                                    • Fracture of head of femur, displaced or nondisplaced
                                                    • Distinguished from femoral neck fracture
                                                    • Occurs due to
                                                      • Posterior dislocation of hip
                                                      • Axial loading trauma
                                                      • Atypical twisting injury at hip

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Scolaro JA et al: Management and radiographic outcomes of femoral head fractures. J Orthop Traumatol. 18(3):235-41, 2017
                                                                                  2. Sheehan SE et al: Proximal femoral fractures: what the orthopedic surgeon wants to know. Radiographics. 35(5):1563-84, 2015
                                                                                  3. Chiron P et al: Fracture-dislocations of the femoral head. Orthop Traumatol Surg Res. 99(1 Suppl):S53-66, 2013
                                                                                  4. Gao YS et al: Injury-to-surgery interval does not affect postfracture osteonecrosis of the femoral head in young adults: a systematic review. Eur J Orthop Surg Traumatol. 23(2):203-9, 2013
                                                                                  5. Ikemura S et al: Subchondral insufficiency fracture of the femoral head: a report of two cases with a history of internal fixation of a femoral neck fracture. Skeletal Radiol. 42(6):849-51, 2013
                                                                                  6. Kosashvili Y et al: Fresh-stored osteochondral allografts for the treatment of femoral head defects: surgical technique and preliminary results. Int Orthop. 37(6):1001-6, 2013
                                                                                  7. Kokubo Y et al: Dislocated intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum: report of 12 cases and technical notes on surgical intervention. Eur J Orthop Surg Traumatol. 23(5):557-64, 2012
                                                                                  8. Clegg TE et al: Hip dislocations--epidemiology, treatment, and outcomes. Injury. 41(4):329-34, 2010
                                                                                  9. Nousiainen MT et al: The use osteochondral allograft in the treatment of a severe femoral head fracture. J Orthop Trauma. 24(2):120-4, 2010
                                                                                  10. Giannoudis PV et al: Management, complications and clinical results of femoral head fractures. Injury. 40(12):1245-51, 2009
                                                                                  11. Iwasaki K et al: Subchondral insufficiency fracture of the femoral head after liver transplantation. Skeletal Radiol. 38(9):925-8, 2009
                                                                                  12. Lee YK et al: Collapsed subchondral fatigue fracture of the femoral head. Orthop Clin North Am. 40(2):259-65, 2009
                                                                                  13. Matsuda DK: A rare fracture, an even rarer treatment: the arthroscopic reduction and internal fixation of an isolated femoral head fracture. Arthroscopy. 25(4):408-12, 2009
                                                                                  14. Yeh LR et al: Diagnostic performance of MR imaging in the assessment of subchondral fractures in avascular necrosis of the femoral head. Skeletal Radiol. 38(6):559-64, 2009
                                                                                  15. Cabarrus MC et al: MRI and CT of insufficiency fractures of the pelvis and the proximal femur. AJR Am J Roentgenol. 191(4):995-1001, 2008
                                                                                  16. Sudo A et al: Bilateral subchondral insufficiency fracture of the femoral head. Orthopedics. 31(4):399, 2008
                                                                                  17. Yamamoto T et al: Subchondral insufficiency fracture of the femoral head in younger adults. Skeletal Radiol. 2006
                                                                                  18. Asghar FA et al: Femoral head fractures: diagnosis, management, and complications. Orthop Clin North Am. 35(4):463-72, 2004
                                                                                  19. Khanna AJ et al: Rapidly destructive osteoarthropathy of the hip. Am J Orthop. 33(5):243-7, 2004
                                                                                  20. Song WS et al: Subchondral fatigue fracture of the femoral head in military recruits. J Bone Joint Surg Am. 86-A(9):1917-24, 2004