Sonoda Kazuhiko, Yamamoto Takuaki, Motomura Goro, Kido Hidehiko, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan.
Skeletal Radiol. 2014 Aug;43(8):1151-3. doi: 10.1007/s00256-014-1835-4. Epub 2014 Feb 14.
Late segmental collapse after internal fixation for femoral neck fracture is the phenomenon observed in post-traumatic osteonecrosis of the femoral head (ON), which has generally been reported to occur over a year or more after internal fixation. Subchondral insufficiency fracture of the femoral head (SIF) has also been recognized to cause femoral head collapse, however, only two cases of SIF after internal fixation for femoral neck fracture have been reported. We report a case with femoral head collapse observed 5 months after internal fixation for femoral neck fracture, which was histopathologically diagnosed as SIF. Clinically, differentiating SIF from ON is important because some cases of SIF have been reported to heal without surgical treatments. The timing of femoral head collapse after femoral neck fracture may be different between SIF and post-traumatic ON.
股骨颈骨折内固定术后晚期节段性塌陷是创伤后股骨头缺血性坏死（ON）中观察到的现象，一般报道其发生在内固定术后一年或更长时间。股骨头软骨下不全骨折（SIF）也被认为可导致股骨头塌陷，然而，股骨颈骨折内固定术后的SIF仅报道过两例。我们报告一例股骨颈骨折内固定术后5个月出现股骨头塌陷的病例，经组织病理学诊断为SIF。临床上，区分SIF和ON很重要，因为据报道一些SIF病例无需手术治疗即可愈合。股骨颈骨折后股骨头塌陷的时间在SIF和创伤后ON之间可能有所不同。
