Summary
Osteonecrosis and acute collapse of the femoral head occurred in a 79-year-old woman with a history of femoral neck fracture sustained 28 years previously. The occurrence of radiographic signs and clinical symptoms was associated with new functional demands on the hip because of a recent contralateral hip fracture. The femoral head collapse necessitated total hip arthroplasty. Determination of femoral head vitality at the time of arthroplasty implicated partial avascularity of the head as a cause of the collapse. With high probability, this partial avascularity was induced by the femoral neck fracture sustained 28 years earlier.
Zusammenfassung
Osteonekrose mit einem akuten Kollaps des Oberschenkelkopfes trat bei einer 79jährigen Frau auf, die vor 28 Jahren eine Oberschenkelhalsfraktur erlitten hatte. Das Auftreten röntgenologischer Veränderungen und klinischer Symptome beruhte auf neuen funktionellen Anforderungen an die Hüfte nach einer neuerlich erlittenen contralateralen, pertrochanteren Fraktur. Der Kollaps des Oberschenkelkopfes machte eine Hüftgelenktotalendoprothese erforderlich. Eine Bestimmung der Oberschenkelkopfvitalität zum Zeitpunkt der Arthroplastik zeigte eine partielle Durchblutungsstörung des Kopfes als Voraussetzung für den Kollaps. Mit großer Wahrscheinlichkeit beruht die Durchblutungsstörung auf der vor 28 Jahren erlittenen Oberschenkelhalsfraktur.
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Strömqvist, B. The longest delay between femoral neck fracture and femoral head collapse?. Arch. Orth. Traum. Surg. 104, 125–128 (1985). https://doi.org/10.1007/BF00454253
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DOI: https://doi.org/10.1007/BF00454253