Subtrochanteric fracture after core decompression for osteonecrosis of the femoral head: a case report and literature review

Shihong Li, Chen Huang,Wei Wang,Song Chen, Bing Deng, Li Yin, Yida Amu,Lijuan Ye, Dan Jing, Benjing Song,Qingyun Xie,Dongfa Liao

BMC Musculoskeletal Disorders(2024)

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Abstract
Osteonecrosis of the femoral head (ONFH) is a common clinical disease. Improper treatment can lead to femoral head collapse and hip joint dysfunction. Core decompression is particularly important for early ONFH. However, subtrochanteric fractures after core decompression cause some clinical problems. This article describes a 34-year-old male patient with early ONFH. After core decompression, he suffered a subtrochanteric fracture of the femur while bearing weight on the affected limb when going up stairs. He was subsequently treated with open reduction and intramedullary nail fixation. When core decompression is used to treat ONFH, the location or size of the drill hole, whether a tantalum rod or bone is inserted, and partial weight-bearing of the affected limb may directly affect whether a fracture occurs after surgery. It is hoped that this case report can provide a reference for clinical orthopedic surgeons in the treatment of early ONFH.
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Key words
Osteonecrosis of the femoral head,Core decompression,Subtrochanteric fracture
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