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Case Reports
. 2025 Jun 1;37(2):164-169.
doi: 10.5371/hp.2025.37.2.164.

Arthroscopic Management for Patients with Secondary Femoroacetabular Impingement Resulting from Femoral Head Fracture Malunion in the Hip

Muhammad Hafiz Daud  1 , Yoichi Murata  1 , Chino Tayag  1 , Soshi Uchida  1
Affiliations
Case Reports

Arthroscopic Management for Patients with Secondary Femoroacetabular Impingement Resulting from Femoral Head Fracture Malunion in the Hip

Muhammad Hafiz Daud et al. Hip Pelvis. .

Abstract

Femoral head fracture malunions resulting in femoroacetabular impingement syndrome are rare complications after the occurrence of femoral head fractures. A 26-year-old female, with a motor vehicle accident history two years prior to our consultation, experienced multiple injuries, including a posterior right dislocation with a femoral head fracture. Although the fracture achieved a successful union with no evidence of osteoarthritis or avascular necrosis, the patient continued to experience hip pain and limited range of motion. We report on a case of femoral head fracture malunion that led to femoroacetabular impingement syndrome. In this case, arthroscopic labral repair, osteoplasty of the femoral head malunion, and capsular closure were performed. At three years post-surgery, the patient was asymptomatic and reported significant improvements in validated hip scores. Arthroscopic management of secondary femoroacetabular impingement is minimally invasive, safe, and beneficial in the treatment of femoral head malunion of the hip.

Keywords: Femoral head fracture; Femoroacetabular impingement; Hip arthroscopy.

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Conflict of interest statement

Conflict of Interest

Soshi Uchida has been a Editorial Board member, but had no role in the decision to publish this article. No other potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Computed tomography (CT) imaging during the postfracture period. (A) Three-dimensional CT image of the pelvis from the posterior view. (B) Two-dimensional CT image showing a suprafoveal fracture of the femoral head. (C) Small fragments observed at the femoral head–neck junction.
Fig. 2
Fig. 2
Preoperative anteroposterior (AP) pelvic radiographs. (A) AP radiograph of the pelvis showing the malunited fragment. (B, C) Computed tomography image showing more details on the location of the malunited fragment (red arrows). (D, E) Magnetic resonance imaging, coronal and sagittal images showing anterosuperior labral tears (green arrows) and thinning of the joint capsule.
Fig. 3
Fig. 3
Arthroscopic findings. (A) View from the anterolateral portal showing a labral tear at the 12:00 to 3:00 position. (B) Arthroscopic view following the completion of labral repair.
Fig. 4
Fig. 4
Arthroscopic images of malunited fragments at the femoral head and neck junction. Images showing the exact location corresponding to the arthroscopic images. (A) Viewing from anterolateral portal, the malunited fragment (arrow) at the anterior junction of the femoral head-neck junction abuts the repaired labrum when the hip was flexed to 60° (arrow). (B) View from the proximal mid-anterior portal, with the hip flexed beyond 60° to visualize the infero-medial malunited fragment (arrow). (C) Arthroscopic images after complete resection of malunion fragments.
Fig. 5
Fig. 5
Comparison of preoperative computed tomography (CT) with 3-month postoperative CT showing complete resection of the malunited fragment (arrows) and correction of cam impingement.
See this image and copyright information in PMC

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