Treatment of Femoral Head Fracture with Traumatic Posterior Dislocation of the Hip.
10.5371/jkhs.2007.19.3.176
- Author:
Jeoung Ho KIM
1
;
Sang Hong LEE
;
Young Lae MOON
;
Dong Hui KIM
;
Kun Sang SONG
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Chosun University, Korea. shalee@chosun.ac.kr
- Publication Type:Original Article
- Keywords:
Femoral head fracture;
Posterior dislocation of the hip;
Pipkin type
- MeSH:
Accidents, Traffic;
Arthritis;
Arthroplasty, Replacement, Hip;
Classification;
Dislocations*;
Follow-Up Studies;
Head*;
Hip*;
Magnetic Resonance Imaging;
Necrosis;
Physical Examination;
Prognosis;
Radiography;
Traction
- From:Journal of the Korean Hip Society
2007;19(3):176-182
- CountryRepublic of Korea
- Language:Korean
-
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.
