J Korean Hip Soc.  2007 Sep;19(3):176-182. 10.5371/jkhs.2007.19.3.176.

Treatment of Femoral Head Fracture with Traumatic Posterior Dislocation of the Hip

• Kim JH
• Lee SH
• Moon YL
• Kim DH
• Song KS

• KMID: 1811335
• DOI: http://doi.org/10.5371/jkhs.2007.19.3.176

Abstract

PUEPOSE: To evaluate the treatment results and complication of a femoral head fracture with posterior dislocation of the hip according to the Pipkin classification.
MATERIALS AND METHODS
Ten cases of Thompson-Epstein type V femoral head fracture with a posterior dislocation of the hip were evaluated. According to the Pipkin classification, 5 cases were type I, 1 case was type III, and 4 cases were type IV. The average age at time of trauma was 38 (19~72) years, and the causes were traffic accidents in 9 cases and falls in 1 case. The average follow-up period was 33 (13~79) months. A reduction of the fracture was performed within 6 hours in 9 cases and 12 hours in 1 case. When the stability was achieved after the reduction, the choice of further treatment was made from either conservative treatment while maintaining skeletal traction, or surgical treatment according to the fracture type and instability. The complications were evaluated by a physical examination, simple radiography, computed tomography (CT) and magnetic resonance imaging (MRI).
RESULTS
In Pipkin type I fractures, 4 cases were treated with conservative treatment and 1 case was treated with surgical treatment. One case of Pipkin type III fracture was treated with primary total hip arthroplasty. In Pipkin type IV fractures, 2 cases were treated surgically using a plate and 2 cases were treated with conservative treatment with skeletal traction. Bone union was achieved in all cases. One case of mild posttraumatic arthritis and 1 case of avascular necrosis was found, respectively in Pipkin type IV.
CONCLUSION
The extent of the initial injury has an effect on the prognosis of a hip fracture and dislocation.

Keyword

Femoral head fracture; Posterior dislocation of the hip; Pipkin type

MeSH Terms

Accidents, Traffic
Arthritis
Arthroplasty, Replacement, Hip
Classification
Dislocations*
Follow-Up Studies
Head*
Hip*
Magnetic Resonance Imaging
Necrosis
Physical Examination
Prognosis
Radiography
Traction