General principles for treatment of femoral head fractures.

Femoral head fractures occur almost exclusively as a result of a traumatic hip dislocation. Treatment is typically an emergency and includes the reduction of the dislocated hip under anesthesia. As a rule, the earlier the reduction, the better the outcome. Open reduction and internal fixation of the fracture of the femoral head is the treatment of choice for most young patients. In some selected cases when there is a very small fragment located in the region below the fovea, removal should be indicated. In elderly patients and those who experience severe femoral head impaction, it is preferable to perform a total hip replacement. Despite optimal management, the rate of complications after femoral head fractures may reach as high as 50%. In the present study, the authors review the general principles of management of patients with femoral head fractures.