Femoroacetabular impingement as a factor in the development of nonunion of the femoral neck: a report of three cases.

Abstract

Description of an anatomic condition where a femoroacetabular impingement was identified as the cause for the development of nonunion of the femoral neck. Retrospective analysis. University hospital. Three patients, aged 27 to 74 years, in whom, after exclusion of other known factors, a femoroacetabular impingement was identified as the cause for the nonunion of a femoral neck fracture. Surgical correction of the femoroacetabular impingement. Intraoperative verification of femoroacetabular impingement. Healing of the femoral neck non-union. In all 3 patients, femoroacetabular impingement was confirmed at surgery. After elimination of the cause for impingement, all nonunions went on to uneventful healing. A femoroacetabular impingement mechanism is proposed as a cause for nonunion of femoral neck fractures. Predisposing factors such as bulging at the fracture site or decreased femoral-neck offset should be addressed at the time of initial fracture treatment.