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Absorbable fixation of femoral head fractures. A prospective study of six cases
K Jukkala-Partio1, E K Partio, E Hirvensalo
1Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Background And Aims:
Fracture of the femoral head associated with a traumatic dislocation of the hip is a rare but severe injury. The methods of the recommended treatment have varied from primary closed or open reduction without fixation to excision of fragments or internal fixation. In our department we have treated other kinds of intra-articular fractures successfully with totally absorbable polyglycolide and poly-L-lactide implants. The aim of this study was to investigate the value of totally absorbable rods and screws in the fixation of the femoral head fractures.
Material And Methods:
Six femoral head fractures associated with a posterior traumatic dislocation of the hip were treated by open reduction and internal fixation using self-reinforced absorbable polyglycolide (SR-PGA) or poly-L-lactide (SR-PLLA) rods and screws. The follow-up time was 38 months in average (range 6 weeks to 77 months).
Results:
In three patients the end results were excellent and in one fair. One patient died six weeks after the accident from the consequences of the cerebral injury. In one 61-year-old patient an arthroplasty was performed one year after the primary osteosynthesis, because of avascular necrosis of the femoral head.
Conclusions:
Self-reinforced polyglycolide and polylactide implants can be used safely to fix femoral head fractures without the need of implant removal.