Relationship Between Intraoperative Femoral Head Bleeding and Development of Avascular Necrosis After Acetabular Fracture Surgery

The purpose of this study was to determine whether the presence or absence of bleeding after drilling of the femoral head can be used to predict the development of avascular necrosis (AVN) after operative treatment of acetabular fractures. A computerized medical record search from 1996 to 2005 of all patients with an operatively treated acetabular fracture yielded 146 patients who had an intraoperative assessment of the vascularity of their femoral head and 72 of whom were available for a minimum of 12 months of follow-up. The average time to the development of AVN was 99.6 weeks with a range of 21–290 weeks. Eleven of the patients in the analysis eventually developed AVN. The p value is not significant at. 092. Although the difference between groups is not significant, it does appear that there is a relationship between femoral head bleeding and the development of avascular necrosis. (Journal of Surgical Orthopaedic Advances 18(3):129–133, 2009)