New surgical algorithm for femoral head split fractures with anatomical study

Area of Science:

• Orthopedic Surgery
• Anatomy
• Traumatology

Background:

• Femoral head split fractures typically occur in the anterior-inferior region.
• Conventional fixation methods often require tenotomy, complicating the procedure.
• A need exists for a safer, effective approach for common femoral head fractures.

Purpose of the Study:

• To develop and evaluate a new anterior surgical approach for femoral head split fractures.
• To identify a safe anatomical corridor within the femoral triangle for fracture fixation.
• To establish a treatment algorithm for specific types of femoral head fractures.

Main Methods:

• Anatomical dissection of 80 femoral triangles to map neurovascular structures.
• Identification of a safe lateral space within the femoral triangle.
• Application of the new anterior approach to 12 patients with femoral head split fractures (2002-2009).

Main Results:

• A safe surgical corridor was identified within the proximal 17.5-32.5% of the rectus femoris.
• Screws were successfully inserted perpendicular to the fracture plane in Brumback type 1A and 2A fractures.
• The anterior approach demonstrated excellent and good outcomes in treated patients.

Conclusions:

• A novel anterior approach utilizing the lateral femoral triangle is effective for treating Brumback type 1A and 2A femoral head split fractures.
• This technique avoids tenotomy and provides a safe fixation method.
• A new treatment algorithm for femoral head split fractures has been developed based on these findings.