Aparato Locomotor

VOL 5 Supl. I  2007


Femoral head post-traumatic necrosis

Oñorbe San Francisco,

F.Gil Garay, E.

Hospital Universitario la Paz


Avascular necrosis appears in over 20% of patients that have suffered hip luxation or transcervical fracture. This is due to the vulnerability of the femoral head vascularization. The risk of necrosis has been correlated to delays in treatment, advanced patient age, fracture displacement, and the presence of associated fractures in the case of luxations.

This disorder constitutes a diagnostic challenge, due to the nonspecific nature of the symptoms and the scant information afforded by conventional X-rays until the more advanced stages have been reached. Magnetic resonance imaging is the diagnostic technique of choice for ensuring early management.

The Ficat classification is the most widely used classification system, since it is very useful for deciding treatment. In early stages, without joint surface involvement, decompression techniques, grafts or osteotomies can be used. In the advanced stages, arthroplasty is the norm.


E. Gil Garay
Hospital de Rehabilitación y Traumatología
Hospital Universitario La Paz
Paseo de la Castellana 261
28046 MADRID
E-mail: egilgaray@msn.com

Patología del Aparato Locomotor, 2007; 5 Supl. I: 2-11

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