Traumatic Ceramic Femoral Head Fracture: An Initial Misdiagnosis

Mohammad H Fard-Aghaie, Mustafa Citak, Joao Correia, Carl Haasper, Thorsten Gehrke, Daniel Kendoff*
Orthopaedic Department, Helios ENDO-Klinik Hamburg, Germany

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© Fard-Aghaie et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Orthopaedic Department, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, D-22767 Hamburg, Germany; Tel: 0049 40 3197 1669; Fax: 0049 40 3197 1200; E-mail:


Background and Purpose:

Ceramic heads are widely used in modern total hip arthroplasty (THA). Although a rare complication, fractures of ceramic heads are described in the literature, evoking uncertainties regarding the in vivo stability of this material, especially when impaction of a fractured ceramic head can lead to disastrous results.


In this case report, we present a fracture of a ceramic head after trauma. A misinterpretation of the initial radiographs led to severe fragmentation of the ceramic head two weeks after the incident, later resulting in complete destruction of the arthroplasty.

Results and Interpretation:

Remarkably, radiographs obtained more than one year after the trauma led to this delayed diagnosis. A single radiographic evaluation, especially in patients with persistent pain after major trauma, with a ceramic head in a THA, seems to be insufficient

Keywords:: Total hip arthroplasty, ceramic head fracture, misdiagnosis, complication, trauma, radiographic evaluation.