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Incidence of Radiographic Cam-Type Impingement in Young Patients (<50) After Femoral Neck Fracture Treated with Reduction and Internal Fixation

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background:

Cam-type femoral impingement is caused by structural abnormalities of the hip and is recognized as a cause of degenerative hip arthritis. Identifiable etiologies of this structural abnormality include congenital malformation, pediatric hip disease, and malunion of femoral neck fractures after internal fixation.

Purpose:

The purpose of this study was to determine the prevalence of radiographic impingement in healed Orthopaedic Trauma Association (OTA) type 31B fractures treated with reduction and internal fixation.

Methods:

Seventy OTA 31B hip fractures treated with internal fixation were identified from our institutional trauma database and radiographs were retrospectively reviewed for signs of impingement. Mean follow-up was 53 months after fracture. Alpha angle, Mose templates, and femoral head retroversion were the measurements used to determine impingement.

Results:

The overall prevalence of any sign of radiographic impingement was 75%. Alpha angle was elevated in 32 hips (46%), asphericity was present in 46 femoral heads (65%), and femoral head retroversion was present in 26 hips (37%). The rates were highest in displaced subcapital fractures (OTA 31B-3) with a 63% (13/19) prevalence of elevated alpha angle, 68% (14/19) prevalence of asphericity, and 47% (10/19) prevalence of retroversion.

Conclusions:

Prevalence of radiographic signs of impingement in this population is higher than expected based on population-based controls. Surgeons must be vigilant about reduction and fixation of femoral neck fractures. Malunion should be recognized as early intervention may be beneficial in improving long-term outcomes.

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Disclosures

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. One or more of the authors has or will receive monies from a commercial entity that may be perceived as a potential conflict of interest.

Each author certifies that his or her institution has approved the reporting of these cases, and that all investigations were conducted in conformity with ethical principles of research.

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Authors and Affiliations

  1. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Matthew C. Wendt MD, Joseph R. Cass MD & Robert R. Trousdale MD

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  1. Matthew C. Wendt MD
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  2. Joseph R. Cass MD
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  3. Robert R. Trousdale MD
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Corresponding author

Correspondence to Robert R. Trousdale MD.

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Level of Evidence: Level IV, Therapeutic study.

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Wendt, M.C., Cass, J.R. & Trousdale, R.R. Incidence of Radiographic Cam-Type Impingement in Young Patients (<50) After Femoral Neck Fracture Treated with Reduction and Internal Fixation. HSS Jrnl 9, 113–117 (2013). https://doi.org/10.1007/s11420-012-9325-5

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  • DOI: https://doi.org/10.1007/s11420-012-9325-5

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