Hip Pain After a Femoral Fracture: It Is Not Always Related to the Implant

• Published in: Orthopedics (Thorofare, N.J.) Vol. 39; no. 6; pp. e1080 - e1084
• Main Authors: White, Brian J, Hawkes, Tara K, Herzog, Mackenzie M
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01-11-2016
• Subjects: Accidents, Traffic; Adult; Arthroscopy; Cartilage; Diaphyses - injuries; Diaphyses - surgery; Female; Femoral Fractures - complications; Femoral Fractures - surgery; Follow-Up Studies; Fracture Fixation, Internal - adverse effects; Fractures; Groin; Hip Injuries - complications; Hip Injuries - surgery; Hip joint; Humans; Injuries; Internal Fixators - adverse effects; Joint Dislocations - complications; Joint Dislocations - surgery; Magnetic resonance imaging; Male; Multiple Trauma - complications; Pain; Pain, Postoperative - etiology; Pathology; Patients; Questionnaires; Retrospective Studies; Rupture - complications; Rupture - surgery; Young Adult; United States > US; Colorado
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20160714-03

The source of continued hip pain following fixation of traumatic femoral shaft fracture is not always clear. Intra-articular hip pathology is often overlooked when evaluating the etiology of residual pain. The purpose of this study was to describe cases of intra-articular hip pathology following traumatic femoral shaft fracture. This was a retrospective case series of patients presenting to a private practice orthopedic clinic from 2012 to 2015. Three patients presented with symptomatic intra-articular hip pathology following traumatic ipsilateral femoral shaft fracture. Patients who underwent hip arthroscopy with allograft labral reconstruction were identified retrospectively. Validated, subjective outcome scores administered included the Modified Harris Hip Score (MHHS), Lower Extremity Functional Scale (LEFS), visual analog scale (VAS) for pain, and VAS scale for patient satisfaction. Three patients were identified with residual, disabling groin pain after femoral shaft fracture fixation following a traumatic motor vehicle accident. All 3 patients were found to have a symptomatic ipsilateral labral tear. In 2 of the patients, an indentation on the lateral femoral head was appreciated, which was hypothesized to be caused by a subluxation event. All 3 patients were treated with arthroscopic hip surgery. At final follow-up, all 3 patients showed significant improvement in MHHS, VAS pain scores, level of satisfaction, and LEFS. Residual pain following ipsilateral femoral shaft fracture is not always related to implant. Intra-articular hip pathology should be considered in patients with lingering hip pain. [Orthopedics. 2016; 39(6):e1080-e1084.].