Purpose: Fractures of the femoral head are relatively uncommon injuries and usually occur following a traumatic dislocation of the hip joint. The purpose of this study was to evaluate self-reported functional outcome of patients who have sustained a femoral head fracture.

Methods: A search of the trauma database at a Level I trauma center between the years 1987–2003 was conducted. Sixty two patients, sustaining 63 femoral head fractures were identified. Two patient-based outcome measures, the Short Form-36 (SF-36) and Short Musculoskeletal Functional Assessment (SMFA) were used to evaluate functional outcome. Forty patients were lost to follow-up including three deaths.

Results: To date twenty-three subjects (13 male, mean age 37.3 +/− 15.6), with 24 femoral head fractures have complete functional outcome data. Ten hips (42%) were classified as Pipkin type I, 12 (50%) type II, 1 (4%) type III, and 1 (4%) type IV. The mean follow-up was 10.3 +/− 5.4 yrs. Mechanism of injury included motor vehicle collisions (18/24), and falls from height (6/24). The mean ISS was 11.3 +/− 5.3. Fifteen subjects were treated operatively (13 internal fixation, 1 excision, 1 open reduction only). Four hips failed initial treatment and required delayed total hip arthroplasty (THA). Subjects (n=20) not having a THA functioned below the Canadian normal population for SF-36 physical component score (mean 44.5 +/− 11.0, p < 0.03).

Conclusions: This is the first report of patient-based functional outcome following treatment of femoral head fractures. Physical function was significantly lower when compared to Canadian population norms.