Femoral Head Fracture

Physical Therapy Videos - Hip and Pelvis

What Is It?

Your hip joint is made up of the top part of your thigh bone (femur) and a socket in your pelvis. The top part of your femur, called the femoral head, is like a ball that fits into the socket. It's covered with cartilage, which helps your hip move smoothly. Muscles are attached to your thigh bone to help you move your leg. The blood vessels to the hip are small and surround the hip joint. If they are damaged with the injury this can cause healing problems.

Graphical picture of a femur. — Figure 1: Model of a femur.

Figure 2: X-rays showing the location of the femoral head.

How It Happens

Hip bone breaks can happen in different situations like sports accidents, car crashes, or motorcycle accidents. These injuries are not common and need special care.

Figure 3: Example of a femoral head fracture on CT scan.

An extreme example of a femoral head fracture, in which the piece was flipped the wrong way. — Figure 4: An example of a femoral head break. The broken piece was flipped the wrong way.

First Steps

If you break your hip bone, you'll likely feel a lot of pain and won't be able to walk. You'll be taken to an emergency room for tests like x-rays or a CT scan. You might need to stay in the hospital for a while to help with pain and to watch your injury. You might need surgery or be placed in "skeletal traction" to help with pain and fix your broken bone. Skeletal traction is used to keep pressure off the broken bones before they are fixed.

Treatment

The goal of treatment is to fix the broken part of your hip bone so it's smooth and round again. This can be done with or without surgery, depending on your injury and other factors like your age and overall health. If you need surgery, your doctor will use special tools to fix your broken bone. They may even cut the femur to help see the broken femoral head better. In some cases, if the damage is too severe, you might need a hip replacement.

A femoral head fracture fixed with screws. — Figure 5: A femoral head break fixed with screws.

A femoral head fracture and a hip socket fracture fixed with plates and screws. — Figure 6: A femoral head break and a hip socket (acetabular) break fixed with plates and screws.

Figure 7: Another femoral head break (left) and a hip socket (acetabular) break (right) fixed with plates and screws.

Recovery

After surgery, it's important to let your bones heal. You'll need to follow your doctor's instructions, which might include not putting weight on your hip and using crutches or a wheelchair. You might work with a physical therapist to help you regain strength and movement. You'll also have regular check-ups to make sure your hip is healing properly.

Long Term

Hip bone breaks are serious injuries because they involve a joint that supports all your weight. You might have complications like infections, blood clots, or long-lasting pain. Sometimes the bones don't heal right or don't heal at all. You might also develop arthritis in your hip joint. These complications might need more treatment, like medications, another surgery, or a hip replacement. Following your doctor's instructions can help lower the risk of complications.