Surgical Approaches for Managing Femoral Head Fractures (FHFs); What and How to Choose from the Different Options?

Abstract

Ahmed A Khalifa,1 Esraa M Ahmed,2 Osama A Farouk3 1Orthopedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt; 2Qena Faculty of Medicine, South Valley University, Qena, Egypt; 3Orthopedic and Traumatology department, Assiut University Hospital, Assiut, EgyptCorrespondence: Ahmed A Khalifa, Orthopedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena, 83523, Egypt, Tel [phone], Fax [phone], Email [email protected]: Femoral head fractures (FHFs) are considered a relatively uncommon injury; however, they carry a challenge to the trauma surgeon. Choosing the appropriate management option, either conservatively or surgically, if the latter was chosen, should it be open reduction and internal fixation or simple excision of the fragment, or acute total hip arthroplasty. Furthermore, selecting the best surgical approach through which surgical management could be performed depends on the fracture classification, the familiarity of the surgeon, and the presence of associated injuries. All approaches to the hip, including hip arthroscopy, had been proposed for the management of FHFs; however, the difference among approaches is related to the complexity of the approach, the need for special training or equipment, the effect of the approach on the functional outcomes as well as the rate of postoperative complications. This review discussed the possible surgical approaches used to manage FHFs, advantages, and disadvantages for each, and offered a guideline for selecting the most appropriate surgical approach.Keywords: femoral head fracture, Pipkin, approaches, Kocher-Langenbeck, Smith-Peterson, surgical hip dislocation

Keywords

• femoral head fracture
• pipkin
• approaches
• kocher-langenbeck
• smith-peterson
• surgical hip dislocation.