Callus formation and the rate of union of nailed fractures of the femur has been determined in 22 patients with associated head injuries and compared with that in a group of patients with similarly treated fractures but without head injuries. The comparison confirms the widely held view that, in patients with head injuries, fractures frequently heal with excessive callus and at a faster rate th...

Osteochondral defects of the femoral head are rare. Several treatment options have been described, though there is currently no consensus on the appropriate management of these lesions. Five patients underwent femoral head osteochondral autograft transfer for treatment of ipsilateral femoral head osteochondral defects via surgical hip dislocation between 2011 and 2014 at our institution. The me...

Of 24 intertrochanteric osteotomies for avascular necrosis of the femoral head, 22 were followed up for an average of 63 months. Sixteen of the 22 cases had good or excellent results, including 5 of the 6 cases with Stage II disease and 11 of the 16 with Stage III changes. Success seemed to be inversely related to the size of the lesion. There were six major orthopaedic complications, but despi...

stage osteonecrosis of the femoral head (ONFH), the factors normally considered are the progression of the disease and the patient’s age. Although most clinicians agree that the focus, when first treating patients under 50 years of age, should be on preserving the joint, there is significant controversy as to the appropriate procedure in any given case. Core decompression is one of the joint sa...

This case deals with the avascular necrosis or osteonecrosis of the femoral head in a 41-year-old male presenting to a chiropractor's office. In addition to the clinical picture, diagnostic imaging should be performed to confirm the presence and extent of hip avascular necrosis. Referral to an orthopedic specialist is key and treatment is mainly surgical.

Cover Picture: Radiograph at six months after internal fixation of the fracture. The Austin-Moore’s pins had crossed the epiphyseal line at the time of the operation. The fracture line is still visible but the Moore’s pins are still holding the fracture. The avascular necrosis involves the entire femoral head. (Refer to page 205-207) “In its beginning the malady (tuberculosis) is easier to cure...

The earliest attempt at classifying avascular necrosis of the femoral head was proposed by Ficat and Arlet in 1964 [2], before the advent of MRI. The purpose of the classification was to provide prognostic insight and compare treatment options. Ficat modified the classification to include invasive testing procedures and a preclinical, preradiographic stage in 1985 [1]. Since then the system has...

This article presents the history and development of as well as the results from the various techniques of vascularized bone grafting for the treatment of osteonecrosis (ON) of the femoral head. The authors have treated more than 2600 patients who had femoral head ON, using a vascularized fibular graft by way of an intraosseous approach. The results from this vast experience are summarized and ...

Total hip replacement in patients with advanced osteonecrosis of the femoral head is often complicated by early loosening of the femoral component. Recent evidence has suggested that abnormal bone extending into the proximal femur may be responsible for the early failure of the femoral component. We aimed to identify which patients were at high risk of early failure by evaluating gadolinium-enh...