Treatment of fracture dislocation of the femoral head using safe surgical hip dislocation: a case report.

We report the clinical and radiological outcomes of a 30-year-old female with femoral head fracture following a posterior hip dislocation. The patient was managed using safe surgical hip dislocation and reviewed the literature on Pipkin type I fractures.

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A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

Journal of Experimental Orthopaedics ◽

10.1186/s40634-021-00362-x ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Alessandro Casiraghi ◽

Claudio Galante ◽

Marco Domenicucci ◽

Stefano Cattaneo ◽

Andrea Achille Spreafico ◽

...

Keyword(s):

Case Report ◽

Femoral Head ◽

Articular Surface ◽

Osteochondral Lesion ◽

Hip Dislocation ◽

Fracture Dislocation ◽

Osteochondral Lesions ◽

Femoral Head Fracture ◽

Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

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Results of surgical hip dislocation in the management of irreducible hip fracture-dislocation with femoral head fracture: a case series

Medical Journal of Tabriz University of Medical Sciences and Health Services ◽

10.34172/mj.2020.051 ◽

2020 ◽

Vol 42 (3) ◽

pp. 319-325

Author(s):

kaveh gharanizadeh ◽

kareem pisoudeh

Keyword(s):

Hip Fracture ◽

Femoral Head ◽

Case Series ◽

Hip Dislocation ◽

Fracture Dislocation ◽

Femoral Head Fracture ◽

Surgical Hip Dislocation

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Asymmetric Bilateral Hip Fracture-Dislocation: A Case Report and Literature Review

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v5i2.3755 ◽

2020 ◽

Author(s):

Seyed Mohammad Javad Mortazavi ◽

Hamed Mazzochy ◽

Mohammad Ali Ghasemi ◽

Furqan Mohammed Yaseen Khan

Keyword(s):

Case Report ◽

Hip Fracture ◽

Femoral Head ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Hip Dislocation ◽

Rare Condition ◽

Initial Step ◽

Fracture Dislocation ◽

Femoral Head Fracture

Background: Asymmetric bilateral hip dislocation is a rare condition, especially when it is accompanied by a bilateral femoral head fracture. Case Report: A 28-year-old man who sustained a motor vehicle accident, was presented to the our center (Imam Khomeini Hospital Complex) with asymmetric bilateral hip fracture-dislocation. In the initial step, closed reduction was performed, followed by bilateral open reduction and fixation of the femoral head fragment by screws. The results were satisfactory after 5 years of follow-up. Conclusion: Although rare, paradoxical femoral head fracture should be considered in patients with hip dislocation. We recommend our therapeutic approach in a similar situation.

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Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04800-w ◽

2021 ◽

Vol 22 (S2) ◽

Author(s):

Domenico De Mauro ◽

Giuseppe Rovere ◽

Amarildo Smakaj ◽

Silvia Marino ◽

Gianluca Ciolli ◽

...

Keyword(s):

Femoral Head ◽

Internal Fixation ◽

Open Reduction ◽

Case Series ◽

Hip Dislocation ◽

Harris Hip Score ◽

Femoral Head Fracture ◽

Surgical Hip Dislocation ◽

Modified Harris Hip Score

Abstract Background The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required. Case presentation Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D’Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9–100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d’Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients. Conclusions Gibson’s approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications.

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Early versus delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation: a comparative study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04968-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Shanxi Wang ◽

Bohua Li ◽

Zhengdong Zhang ◽

Xiaojun Yu ◽

Qin Li ◽

...

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Fracture Healing ◽

Hip Dislocation ◽

Healing Time ◽

Early Group ◽

Femoral Head Fracture ◽

Hip Reduction ◽

Delayed Group ◽

Posterior Hip Dislocation

Abstract Background Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the safe interval time between injury and hip reduction remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation. Methods A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 h after injury) and delayed group (between 6 and 12 h after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation. Results The mean hospital stay and fracture healing time in the early group were significantly lower than those in the delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than that in the early group. The early group had better functional outcomes in terms of Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores and physical component scale (PCS) than the delayed group. Conclusions For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient rehabilitation, and obtain a better functional outcome.

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Delayed diagnosis of traumatic posterior hip dislocation in a 6-year-old girl with 6 years follow up: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20174526 ◽

2017 ◽

Vol 4 (10) ◽

pp. 3511

Author(s):

Paa Kwesi Baidoo ◽

Boniface Adegah

Keyword(s):

Case Report ◽

Femoral Head ◽

Avascular Necrosis ◽

Delayed Diagnosis ◽

Hip Dislocation ◽

Traumatic Hip Dislocation ◽

Left Posterior ◽

Posterior Hip Dislocation

Though uncommon, cases of traumatic hip dislocation have been reported in children worldwide. Averagely, it is recommended that the acceptable duration for reduction after such dislocations is about 6 hours. Even with that there is about 5% documented chance of developing avascular necrosis of the head of the femur. The incidence of avascular necrosis increases with delayed relocation of the femoral head. We report a case involving a 6-year-old girl with a 2-week delayed diagnosis of a left posterior hip dislocation that was reduced and followed up for 6 years.

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Avascular necrosis of the femoral head in the patients with posterior wall acetabular fractures associated with dislocations of the hip

Acta chirurgica iugoslavica ◽

10.2298/aci1302065m ◽

2013 ◽

Vol 60 (2) ◽

pp. 65-69 ◽

Cited By ~ 4

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Jordan Saveski ◽

Ivan Micic ◽

Predrag Stojiljkovic ◽

...

Keyword(s):

Femoral Head ◽

Young Patients ◽

Hip Dislocation ◽

Posterior Wall ◽

Acetabular Fractures ◽

Type I ◽

Severe Injuries ◽

Stable Osteosynthesis ◽

Posterior Hip Dislocation

Introduction: Acetabular fractures are severe injuries, mostly occured in young patients after traffic accident or fall from heights. Of the all acetabular fractures, posterior wall acetabular fractures are the most often observed. Regarding to mechanism of the injury, about 30% of these fractures are associated with posterior hip dislocation. Material and methods: The incidence of AVN in 18 patients with posterior wall acetabular fractures associated with dislocations of the hip is presented. Thompson-Epstein Scale (type I-V) was used as the classification of the injury. Kocher-Langenbeck surgical approach was achieved in all patients. Results: Average following time after surgery was 22,66 months (8-36 months). After that period the incidence of femoral head AVN was observed in 33,3%6. Femoral head AVN was observed in 5,55%1 of patient who was treated by the reduction of hip dislocation in first 24 hours after injury, while in patients with later reduction, femoral head AVN were observed in 27,77%5. Conclusion: Posterior wall acetabular fractures associated with hip dislocation are severe injuries. Urgent, closed reduction of the hip, early definitive stable osteosynthesis of acetabulum and the experience of surgical team are factors that greatly decrease the possibility for AVN occurrence. Later reduction, comminution of posterior wall of the acetabulum (Thompson-Epstein III et IV), impaction, chondral lesion of the femoral head and associated fractures of femoral head, increase the possibility for AVN occurrence.

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Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

10.21203/rs.3.rs-515176/v1 ◽

2021 ◽

Author(s):

Shanxi Wang ◽

Bohua Li ◽

Zhengdong Zhang ◽

Xiaojun Yu ◽

Qin Li ◽

...

Keyword(s):

Femoral Head ◽

Fracture Healing ◽

Functional Outcomes ◽

Hip Dislocation ◽

Healing Time ◽

Early Group ◽

Femoral Head Fracture ◽

Hip Reduction ◽

Delayed Group ◽

Posterior Hip Dislocation

Abstract Background: Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the the safe interval time between injury and reduction still remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in treating femoral head fracture combined with posterior hip dislocation. Methods: A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 hours after injury) and delayed group (between 6 - 12 hours after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation.Results: The mean hospital day and fracture healing time in the early group were significantly lower than delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than early group. The early group had better functional outcomes in term of Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores and physical component scale (PCS) than delayed group. Conclusions: For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient recovery as well as obtain better functional outcomes.

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