A rare case of an irreducible Pipkin II fracture-dislocation of the femoral head in a young patient following low-energy trauma.

INTRODUCTION

Fractures-dislocations of the femoral head are rare, and irreducible dislocations are even rarer. The functional prognosis is poor.

PRESENTATION OF CASE: We report the case of a 23-year-old male brought to the emergency room following low-energy trauma. X-rays and a computed tomography scan revealed a Pipkin II fracture-dislocation of the right femoral head. We attempted reduction with the patient under general anesthesia; this failed, so we proceeded to total hip arthroplasty (THA).

DISCUSSION: A femoral head fracture has a poor prognosis; the principal complications are osteonecrosis, osteoarthritis, and heterotopic ossifications. No surgical treatment algorithm for a femoral head fracture (for fragment excision, followed by internal fixation or THA) is available, given the rarity of the injury and the lack of sufficient cases.

CONCLUSIONS

We describe the mechanism of low-energy injury, as well as the controversial THA treatment chosen by this young patient.