大腿骨転子部骨折術後に骨頭壊死を生じた 1 例

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  • Avascular Necrosis of the Femoral Head after Intertrochanteric Fracture : A Case Report

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Avascular necrosis of the femoral head (ANFH) after intertrochanteric fracture is uncommon. We reported a 93-year-old woman sustained this unusual complication. Internal fixation was performed, using a compression hip screw. Four months after surgery the patient was able to walk with the aid of a cane, was discharged from the hospital. However, at 6 months after surgery, she complained her hip pain without any cause. We diagnosed ANFN on the basis of radiological findings, and performed bipolar hip hemi-arthroplasty. The possible etiology of the complication was damage to the vascular supply (posterosuperior retinacular artery and/or deep branch of the medial circumflex femoral artery) of the femoral head. The possible risk factors for such vascular damage are a proximal intertrochanteric fracture line similar to the basal neck fracture, fractures with displacement of the fragments, fractures with comminution, and excessive external rotation of the limb in fixation. This case may be caused by what fracture lime is similar to basal neck fracture and external rotation of the limb.

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