Khizar Hayat, Kashif Ashfaq, Imtiaz A Tago, Anisuddin Bhatti, Saeed Minhas, Ghulam Mehboob.
Factors related to development of traumatic osteonecrosis of femoral head.
J Pak Orthop Assoc Jan ;20(2):108-13.

Objective: To evaluate the factors which are implicated in the development of traumatic osteonecrosis of femoral head. Study design: This is a descriptive, non-randomized study. Place and duration of study: This study was conducted at the Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, from March 2004 to September 2005. Patients and Methods: 30 patients of either sex with age ranging from 16-45 years with the diagnosis of traumatic avascular necrosis were evaluated particularly for type of injury, time until reduction, accuracy of reduction and fracture displacement. Results: Out of 30 selected patients, 22 (73.3%) were males and 8(26.7%) were females. Twenty patients (66.6%) were of fracture neck of femur. Out of these, 18 had (60%) displaced fracture, whereas remaining 2patients (6%) had undisplaced fracture neck of femur. Ten patients (30%) were of fracture dislocation of hip, among which 9 patients (27%) were of posterior dislocation of the hip, while one patient (3%) was a case of anterior fracture dislocation of the hip. Time to definite treatment from injury was within 12 hours in 7 of the patients (23.33%), 12 – 24 hours in 10 patients (33.33%), 24 – 48 hours in 8 patients (26.66%), whereas remaining 5 patients (16.66%) were treated one week after the injury. Conclusion: Trauma is the most common cause of Avascular necrosis of femoral head. For the prevention of Avascular necrosis of femoral head, it is essential to fix displaced fracture as early as possible, as well as early relocation and fixation of fracture dislocation of hip joint and good follow-up till rehabilitation.

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