Assessment of Vascularity of Femoral Head after Post-traumatic Fracture Neck of Femur of Variable Period

Background: Fracture neck of femur always poses a big challenge to surgeons. In our country, the majority of them come from low socio-economic status and have to do hard field labor to maintain a household. So, preservation of femoral head should be given the priority during their treatment. Objectives: It is presumptive to have some idea about the vascular status of the femoral head as they often present late. Our objective is to study the histopathology of femoral head sacrificed during operation so that we can have an idea regarding the vascular supply of femoral head and to determine up to which extent we can conserve the femoral head. Materials and Methods: This is an institutional based longitudinal observation study conducted at IPGMER and SSKM Hospital Kolkata from May 2013 to April 2014 comprising 32 patients aged 55 years and above having fresh post-traumatic fracture neck of femur admitted for hemiarthroplasty. All sacrificed heads were studied histopathologically from different quadrants for vascularity changes for a variable period up to 4 weeks. Results: All data are statistically evaluated. There is a gradual decrease in viability and vascularity of different quadrants of the femoral head with increasing time except foveal areas. There were no statistical sex differences of vascularity changes. The significant difference found in displaced and undisplaced fractures. Conclusions: As there is a proportional relationship between time elapsed after trauma and avascular necrosis change, assessment of vascularity of femoral head should be done before sacrificing it routinely.