$impacted subcapital fracture$

$impacted subcapital fracture$

8A, Anteroposterior radiograph shows no fracture line. MR imaging findings include an incomplete fracture line surrounded by intraosseous edema (figure 8C).įig. They are usually occult fractures as they remain as non-displaced.Īt early stages plain film radiographs may show no changes (figure 8A).Īfter progression plain films may show some findings such as trabecular interruption,Ĭallus formation and partial or complete fracture line without displacement.Ĭomputed tomography examinations show an incomplete fracture line surrounded by sclerotic bone (figure 8B). Most stress fractures of the femoral neck are incomplete. MR imaging shows bone marrow edema of the femoral head and neck in T2-weighted sequences and a subchondral hypointense wavy line on T1-weighted sequences. Superolateral collapse of the femoral head,īone scintigraphy may demonstrate an increased uptake of the femoral head. Most of plain radiographs do not show any finding during the first 3 months.Īfter this period they may show mixed altered radiodensity, Renal transplant recipients and also in athletes. Which may appear in osteoporotic overweight patients, Subchondral insufficiency fractures of the femoral head occur in absence of major trauma because of cortical bone weakening, Subchondral fractures of the femoral head 7B, MDCT coronal reformatted image shows an osteochondral impaction (black arrowhead).

$impacted subcapital fracture$

A radiolucent line (white arrowhead) is the only finding which delates a head fracture. 7A, Anteroposterior plain film shows an anterior dislocation of the femoral head. 7: Hip dislocation and osteochondral impaction of the femoral head. Recognition of the appearance of subcapital hip fractures mimicking pathologic fractures and knowledge of the cause of this finding are important for prescribing appropriate treatment.Fig. This appearance is caused primarily by rotation of the fracture fragments, and the finding is accentuated by displacement. The radiographic appearance of subcapital fractures of the femoral neck unrelated to neoplasm is often similar to that of pathologic fractures. Study of the cadaveric femoral specimens showed that the radiographic appearance simulating a pathologic fracture was primarily caused by external rotation of the distal fracture fragment and was accentuated by displacement between fracture fragments. This finding occurred only with Garden stage III fractures (n = 7, 32% of Garden stage III fractures) or Garden stage IV fractures (n = 10, 24% of Garden stage IV fractures). Seventeen (17%) of the 100 subcapital fractures had a radiographic appearance similar to that of a pathologic fracture. Cadaveric femurs (n = 6) were fractured and studied radiographically. Fracture configuration was classified by using the Garden staging system. Preoperative radiographs were analyzed for the presence of findings suggesting a pathologic fracture. In the other patients, follow-up radiographs, clinical evaluation, and pathology reports were used to exclude neoplastic involvement.

$impacted subcapital fracture$

Review of intraoperative biopsy specimens, available in 69 patients, revealed no evidence of neoplasm in any case. Radiographs were available in 100 of these cases. Our purpose was to determine the prevalence of this finding and the anatomic variations of fracture alignment that cause this appearance.Īll subcapital nonpathologic hip fractures (n = 111) that occurred at our institution during a 5-year period were reviewed. Occasionally, radiographs of the hip in these patients show a radiolucency in the superolateral, subcapital region of the femoral neck that mimics the features of a pathologic fracture. Subcapital fractures of the femoral neck are common in elderly persons who have osteoporosis.

$impacted subcapital fracture$

Impacted subcapital fracture