Hip subluxation associated with Pipkin II fracture: an injury to look for before reduction

Abstract

Fractures of the femoral head are rare. They usually occur in association with a posterior hip dislocation secondary to a high-energy trauma (motor vehicle accident). We report a case of Pipkin II fracture associated with an irreducible hip subluxation. Clinical signs are poor unlike in posterior hip subluxation. CT scan is important to evaluate the traumatism. The Hardinge approach is relevant in this context of irreducible hip subluxation. The clinical, diagnostic, and therapeutic particularities of this lesion type are discussed.

Irreducible Femur Head Fracture-Dislocation Treatment With Kocher-Langenbeck Approach With Flip Trochanteric Osteotomy: A Novel Approach

“…Commonly in such types of cases, the proximal femur herniates through the superior-posterior gap between the acetabular rim and the labrum [10,11]. Other causes of irreducibility are interposition of pyriformis, ligamentum teres, labrum, and, sometimes, buttonholing through the posterior capsule [12,13]. Sometimes, the rotation of the head fragment around the ligamentum teres and osteochondral fragment prevent reduction.…”

Clinical results of femoral head fracture-dislocation treated according to the Pipkin classification

“…Because it is seldom seen in clinical practice, the surgeons always focus on the femoral head dislocation and the minor fracture fragments from the femoral head can be easily missed 2. The missed diagnosis of Pipkin fracture will cause poor prognosis unless the patient accepts the total hip arthroplasty (THA) on initial presentation since it can be easily cause late onset of femoral head necrosis and traumatic arthritis 3.…”