Femoral head fractures

Abstract

Femoral head fractures may present in various patterns with or without associated fractures around the hip. As a result, the treating orthopaedic surgeon must understand not only the fracture pattern, but also patientrelated fractures and the relevant operative exposures and reconstructive options to achieve the best functional outcome while minimizing complications. Treatment options range from non-operative treatment to fracture fragment excision or fracture fixation using various surgical exposures and implants. This article reviews the current literature on the treatment options for femoral head fractures and presents modern operative techniques that have improved exposure of the fracture while minimizing associated risks such as avascular necrosis, heterotopic ossification, and neurovascular compromise. A sound understanding of the anatomy and these newer techniques can enable the surgeon to provide improved expectations and clinical outcomes.

Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know

“…Complete Femoral Head Fractures.-Fractures of the femoral head are uncommon injuries that are most often associated with posterior hip dislocations from high-energy mechanisms such as motor vehicle collisions or falls from great heights, but also from contact sports injuries, snowboarding and skiing injuries, industrial accidents, or relatively lowenergy falls without dislocation (16,17). Posterior dislocation most often results from impact on the flexed knee with the hip in mild flexion and in the neutral or slightly adducted and internally rotated position, as in a "dashboard" injury mechanism (Fig 4) (18).…”

“…Multiple classification systems for proximal femoral fracture-dislocations have been described in the literature, but the morphologic classification system proposed by Pipkin (17) remains the most widely used (16). The Pipkin system classifies femoral head fracture-dislocations into four types, depending on the morphologic features of the femoral head fracture and the presence or absence of an associated femoral neck or acetabular fracture ( Fig 5).…”

“…The Pipkin system classifies femoral head fracture-dislocations into four types, depending on the morphologic features of the femoral head fracture and the presence or absence of an associated femoral neck or acetabular fracture ( Fig 5). The Pipkin system is favored due to its simplicity of use, its ability to help estimate subsequent risk of long-term complications, and its utility in directing early surgical management (16,21,22).…”

Ganz Surgical Dislocation of the Hip Is a Safe Technique for Operative Treatment of Pipkin Fractures. Results of a Prospective Trial

“…4 Operative treatment is generally preferred to ensure joint congruity, early mobilization, and to prevent long-term complications. 5 Although Pipkin type I fractures can be fixed or excised, 6 fixation is usually recommended for type II fractures. 7 Anterior surgical dislocation is widely recommended for operative treatment, 8,9 which can be performed either through a SmithPeterson 10 or the Ganz approach.…”

Alt Ekstremite Travmasi

“…Ligamentum teresin avül-siyonu veya femur başının asetabulum üzerinde mekanik etkisi sonucu ortaya çıkar. En yaygın kullanılan sınıflama Pipkin sınıflamasıdır [3,4]. Dört tip tanımlanmıştır.…”