J Korean Orthop Assoc.  2009 Aug;44(4):495-498.

Osteonecrosis of Femoral Head after Pelvic Fracture: A Case Report

• Park YS
• Kim JH
• Kim YH
• Park KC

Abstract

We report on a case of osteonecrosis of the femoral head after a traumatic pelvic injury, and this was not associated with skeletal injuries to his hip joint. An adolescent male developed ostenecrosis of the femoral head following a pelvic fracture, but his hip joint was not injured by the pelvic fracture. To the best of our knowledge, such a finding has not been previously reported. The risk factors fot osteonecrosis are also reviewed.

Keyword

Pelvic bone fracture; Osteonecrosis

MeSH Terms

Adolescent
Head
Hip Joint
Humans
Male
Osteonecrosis
Risk Factors

Figure

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  Fig. 1 Anteroposterior radiograph of pelvis on arrival, showing Type C pelvic fracture.

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  Fig. 2 Axial view of pelvis CT on day of arrival showing no dislocation of hip joint.

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  Fig. 3 Axial view of pelvis showing separation of right SI joint with retroperitoneal hematoma.

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  Fig. 4 10 week post-operative anteroposterior radiograph of pelvis, showing early collapse of femoral head.

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  Fig. 5 T2 weighted magnetic resonance image showing collapse of the subchondral surface and edema within femoral head, thus confirming osteonecrosis of femoral head.

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  Fig. 6 18 month postoperative radiograph of pelvis, showing further collapse of femoral head and leg discrepancy.

Reference

1. Stougard J. Post-traumatic avascular necrosis of the femoral head in children. Report of two cases. J Bone Joint Surg Br. 1969. 51:354–355.

2. Bartonícek J, Fric V, Skála-Rosenbaum J, Dousa P. Avascular necrosis of the femoral head in pertrochanteric fractures: a report of 8 cases and a review of the literature. J Orthop Trauma. 2007. 21:229–236.

3. Moorman CT 3rd, Warren RF, Hershman EB, et al. Traumatic posterior hip subluxation in American football. J Bone Joint Surg Am. 2003. 85:1190–1196.

4. Lafforgue P. Pathophysiology and natural history of avascular necrosis of bone. Joint Bone Spine. 2006. 73:500–507.

5. Song KS, Kim YS, Sohn SW, Ogden JA. Arthrotomy and open reduction of the displaced fracture of the femoral neck in children. J Pediatr Orthop B. 2001. 10:205–214.

6. Jones JP Jr, Sakovich L. Fat embolism of bone. A roentgenographic and histological investigation, with use of intra-arterial lipiodol, in rabbits. J Bone Joint Surg Am. 1966. 48:149–164.