Femoral head fracture associated with dislocation and bilateral acetabular fracture
case report and a brief literature review
DOI:
https://doi.org/10.24220/2318-0897v33a2025e8668Keywords:
Femur head, Hip fractures, Hip dislocationAbstract
The femoral head fracture was first described in 1869 by Birket, it corresponds to a rare injury, occurring in 5% to 15% of hip dislocations. Among the grades defined by Pipkin, grades I, II and IV are the most common, while grade III is the rarest. Although this classification did not originally present a prognostic value, later studies point to grade IV lesion as the one with the worst prognosis. The present study aims to report a case of bilateral femoral head fracture, Pipkin I on the left and Pipkin IV on the right, accompanied by dislocations. Report: Male patient, 24 years old, smoker, without comorbidities, suffered an automobile accident when colliding head-on with a tractor at high speed. An X-ray showed a bilateral posterior hip dislocation concomitant with a bilateral femoral head fracture, and thus an emergency closed reduction was performed. Surgical treatment was performed in two stages. Discussion: As hip dislocation is an orthopedic emergency, reduction should be performed as soon as possible, being careful to not contribute to an iatrogenic Pipkin grade III femoral neck fracture. Conclusion: Regardless of treatment, the prognosis is poor. Although further studies are lacking, total hip arthroplasty is a likely option. In our case, the patient progressed well in the first months, but presented later with bilateral vascular necrosis and post-traumatic arthrosis on the right.
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