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  • Title: [Diagnosis and misdiagnosis of fracture of the femoral head].
    Author: Zhu L, Lin H, Luo D.
    Journal: Zhonghua Wai Ke Za Zhi; 1995 May; 33(5):289-91. PubMed ID: 7587695.
    Abstract:
    164 cases of traumatic posterior dislocation of the hip, of which 26 were associated with fractures of the femoral head, about 15.9% incidence, were treated during the year from March 1982 to March 1993. According to the pipkin classification of fractures of the femoral head, 10 cases were type 1, 6 tupe 2, 2 type 3, and 8 type 4. Of the 26 cases, 24 received emergent radiography, with 22 diagnosed and 2 misdiagnosed. The other 2 cases were found prompt auto-reduction of dislocation of the femoral head, without emergent radiography. The 4 misdiagnosed cases, because of continued pain or redislocation, came back later for radiography and then were correctly diagnosed. Besides the routine anteroposterior radiograph of the hip, pelvic oblique radiography angled 45 degrees or 60 degrees, and frog-leg anteroposterior hip radiography were needed. The CT-directed pelvic oblique radiograph was found to be the most accurate determinant of the extent of fracture displacement and the presence of intrasarticular loose fragments. Among the 19 cases operated on, 16 showed excellent-good rate (50%), and among the 7 non-operated cases, of 6 showed excellent-good rate (33%). After follow up.
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