Hemodynamic measurement in the femoral head using laser Doppler

The author used a laser Doppler device to measure hemodynamics in the femoral head. Twenty-eight patients with femoral neck fractures, 16 patients with intertrochanteric fractures, and 14 patients with osteoarthritis were studied. Through a lateral approach, a small hole was drilled into the femoral head using a burr, and a probe was inserted to measure intramedullary flow. The flow measurements were high and sinusoidal in shape (corresponding with the heart rate) in all Garden 1, all Garden 2, and in four of six Garden 3 femoral neck fractures. Flow measurements were low and not sinusoidal in two of six Gardens 3 and all Garden 4 fractures. Hemodynamic values were high in all 16 patients with intertrochanteric fractures and all 14 patients with osteoarthritis. Although the posterior column arteries were cut while the intramedullary hemodynamics were being measured in patients with osteoarthritis of the hips, the measured values still were high. The postero-lateral area of the femoral head was fed compensatorily by the inferior retinacular arteries. The laser Doppler is useful in estimating circulatory compromise.