LAUSR

OBJECTIVE To evaluate the clinical and patient-reported outcomes of patients with femoral head fractures treated at a single level I trauma center with a minimum 10-year follow-up. DESIGN Retrospective review SETTING:: Academic Level-1 Trauma Center PATIENTS/PARTICIPANTS:: One hundred and one consecutive femoral head fractures were identified for this study. The final study group consisted of 28 patients with a minimum of 10-years of clinical follow-up. INTERVENTION All patients were treated with one or in combination with the following treatments: nonoperative management, open reduction and internal fixation, fragment excision, or total hip arthroplasty. MAIN OUTCOME MEASURES Oxford Hip Score at final follow-up along with clinical and radiological complications; infection, avascular necrosis, post-traumatic osteoarthritis, heterotopic ossification, and conversion to total hip arthroplasty. RESULTS Twenty-eight patients with greater than 10 years of follow-up were included in this evaluation. The average follow-up was 14 years and the average age was 39.2 years. Surgical management occurred in 86% of patients, and the mean time to definitive treatment was 3.7 days. Overall, 21 patients (75%) experienced a complication. Seven patients (30%) were later converted to a total hip arthroplasty (THA) at an average of 6.4 years from initial injury. Three of the seven late THA conversions (43%) required later revision. Oxford hip scores (OHS) were obtained in all 28 patients at final follow-up. The average OHS was 36.6. The mean OHS of the native hips was 37 at an average follow-up of 13.6 years. The mean OHS of primary THA was 41 and the mean OHS of secondary THA at final follow-up was 31.4, but this was not statistically significant (p = .134). CONCLUSIONS Patients should be counseled that the long-term results of open reduction and internal fixation may be satisfactory but unfortunately are not predictable. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.