This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.

Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.

The average Merle d'Aubigne'-Postel score was 12.8 (12.80±3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83±2.79), and that for the open reduction and internal fixation group was 13.9 (13.92±3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.

Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.