Early detection and classification of collapse of femoral head after transcervical fracture
Cai, R.B.; Nie, Q.D.
Chinese Medical Journal 95(1): 25-30
1982
ISSN/ISBN: 0366-6999 PMID: 6802577 Document Number: 191014
Long term follow up observations are carried out in 103 cases of avascular necrotic femoral head collapse after transcervical fractures. A method of detecting minimal femoral head collapse and classification of its stages and types are presented which helps early diagnosis, estimation of prognosis and selection of treatment. Criteria and radiologic signs for the detection of femoral head collapse are: time of occurrence, appearance of nail trace, recurrence of pain, gradual lowering of femoral head height and appearance of a sclerotic-radiolucent zone. A method of measuring femoral head height is devised and reported. Correct interpretation of the criteria and radiologic signs during minimal collapse is considered the key to increasing the efficacy of treatment. Femoral head collapse after transcervical fracture is classified into 3 types, weightbearing area collapse, total collapse and subtotal collapse. Subtotal collapse is a new type proposed here with its own clinical features. During the progressive stage, weightbearing area collapse retains the best function, subtotal collapse the next and total collapse the worst. Features of the quiescent stage of collapse are also classified into 3 types, prognosis of the repair type is the best, sclerotic type the 2nd and absorption type worst.