Hip Pelvis.  2014 Mar;26(1):36-40. 10.5371/hp.2014.26.1.36.

Arthroscopic Fragment Excision of Pipkin Type I Displaced Femoral Head Fracture: A Case Report

• Kim CK
• Chung WC
• Song JH
• Park JY
• Jung BH

• KMID: 2054160
• DOI: http://doi.org/10.5371/hp.2014.26.1.36

Abstract

There has been a variety of options for treatment of femoral head fracture with hip dislocation according to the Pipkin classification. Pipkin type I fractures with minimal displacement have been treated conservatively. However, in cases where the fracture was displaced or reduced incongruently, it has been treated by open fragment excision or fixation after reduction. In our case, the patient was a 62-year-old man who sustained a displaced fracture of Pipkin type I. We achieved a satisfactory outcome by arthroscopic excision of a displaced bony fragment and small bony fragments that could not be confirmed by pre-operative imaging study. Therefore, we report on the case with a review of the literature.

Keyword

Displaced femoral head fracture; Pipkin type I; Arthroscopic excision

MeSH Terms

Classification
Head*
Hip Dislocation
Humans
Middle Aged

Figure

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  Fig. 1 (A) The right hip was dislocated posteriorly and femoral head fracture was seen. (B) Closed reduction was done. But femoral head fragment (arrow) was displaced reversely. (C) Computed tomographic image of the right hip showed reversely displaced femoral head fragment.

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  Fig. 2 (A) Avulsion bony fragment with ligamentum teres (asterisk) was seen. (B) It was excised. (C) In peripheral portion, there was a large bony fragment. (D) The bone fragment was too large to be removed through portal, so we decide to crush the fragment to pieces by awl. (E, F) After removal, there was no any other fragment.

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  Fig. 3 The bony fragments was removed.

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  Fig. 4 Six months later, the right hip joint congruency was acceptable and the patient had no pain in walking.

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