Fixation of femoral head fractures with autologous osteochondral transfer (mosaicplasty).

Posterior fracture dislocation of the femoral head is a rare entity usually requiring open reduction and internal fixation. Results of different fixation methods have been reported, including countersinking screws, headless screws, and bioabsorbable implants. Osteochondral autologous transfer (mosaicplasty) is an established method of treatment of full thickness cartilage defects of the knee, ankle, and elbow. At our institution, posterior fracture-dislocations of the femoral head were treated with femoral head fragment fixation using osteochondral autografts through surgical hip dislocation. Osteochondral plugs were harvested from the non-weight-bearing area of the lateral femoral condyle of the knee and used for fixation of the reduced fragment. This article details the technique and its application.