TY - JOUR
T1 - Clinical and imaging features of a subchondral insufficiency fracture of the femoral head after internal fixation of a femoral neck fracture
T2 - A comparison with those of post-traumatic osteonecrosis of the femoral head
AU - Ikemura, Satoshi
AU - Yamashita, Akihisa
AU - Harada, Takashi
AU - Watanabe, Tetsuya
AU - Shirasawa, Kenzo
N1 - Publisher Copyright:
© 2016 The Authors.
PY - 2016
Y1 - 2016
N2 - Objective: Recent articles have demonstrated that subchondral insufficiency fractures (SIFs) of the femoral head can occur following internal fixation of femoral neck fractures (FNFs), in addition to post-traumatic osteonecrosis (ON) of the femoral head. The purpose of this study was to determine the clinical and imaging features of SIF after internal fixation of FNFs compared with those of post-traumatic ON. Methods: We reviewed five hips in five patients, who received internal fixation for the treatment of FNF and were diagnosed as having SIF according to the shape of the low-intensity band on the T1 weighted MR image. Four hips of four patients with post-traumatic ON were compared with the SIF cases. Both the clinical and imaging findings were investigated. Results: There were no significant differences in the age, sex, body mass index, stage of FNF or duration from injury to surgery between SIF and post-traumatic ON. Regarding the prognosis, one of the five cases (20%) with SIF underwent prosthetic replacement owing to a progressive collapse of the femoral head. Two of the four cases (50%) with post-traumatic ON underwent prosthetic replacement. Conclusion: The results of this study suggest that SIF should be considered a possible condition following the internal fixation of FNFs, and it is important to differentiate SIF from post-traumatic ON.
AB - Objective: Recent articles have demonstrated that subchondral insufficiency fractures (SIFs) of the femoral head can occur following internal fixation of femoral neck fractures (FNFs), in addition to post-traumatic osteonecrosis (ON) of the femoral head. The purpose of this study was to determine the clinical and imaging features of SIF after internal fixation of FNFs compared with those of post-traumatic ON. Methods: We reviewed five hips in five patients, who received internal fixation for the treatment of FNF and were diagnosed as having SIF according to the shape of the low-intensity band on the T1 weighted MR image. Four hips of four patients with post-traumatic ON were compared with the SIF cases. Both the clinical and imaging findings were investigated. Results: There were no significant differences in the age, sex, body mass index, stage of FNF or duration from injury to surgery between SIF and post-traumatic ON. Regarding the prognosis, one of the five cases (20%) with SIF underwent prosthetic replacement owing to a progressive collapse of the femoral head. Two of the four cases (50%) with post-traumatic ON underwent prosthetic replacement. Conclusion: The results of this study suggest that SIF should be considered a possible condition following the internal fixation of FNFs, and it is important to differentiate SIF from post-traumatic ON.
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U2 - 10.1259/bjr.20150725
DO - 10.1259/bjr.20150725
M3 - Article
C2 - 26828970
AN - SCOPUS:84989859766
VL - 89
JO - British Journal of Radiology
JF - British Journal of Radiology
SN - 0007-1285
IS - 1060
M1 - 20150725
ER -