Femoral Head Fracture

Mechanism Clinical Findings Concomitant Injuries ED Management Disposition and Follow-Up Complications
Isolated fracture rare; seen in 6%–16% of hip dislocations; usually result of high-energy trauma; dashboard to flexed knee most common Superior aspect or impaction fracture in anterior dislocation; inferior aspect in posterior dislocation Limb shortened and externally rotated (anterior dislocation); shortened, flexed, and internally rotated (posterior dislocation) Closed head injury; intrathoracic and/or intra-abdominal injuries; pelvic fracture, knee injuries Immediate orthopedic consultation; Emergent closed reduction of dislocation; ORIF if closed unsuccessful Admission to orthopedic or trauma service AVN; post-traumatic arthritis; sciatic nerve injury; heterotopic ossification