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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2001 December;52(6):269-74
Femoral-head fracture-dislocation. A case report and literature survey
De Bellis U., Castelli F., D'Imporzano M.
The fracture-dislocation of the femoral head is a rare event of difficult treatment and prognosis. The most useful classification is that described by Pipkin. For a correct therapeutic schedule a CT examination is necessary in order to evaluate the exact dimension of the fragment as well as the presence of articular incongruence. Possibly, the fracture's reduction should be carried out within 6 hours from the traumatic event. The treatment should consider the fragment's dimension, the joint's incongruence, the age of the patient as well as the possibility of perfect reduction without surgical approach. Internal fixation is indicated if the fragment is at least 1/3 of the femoral head, as usually happens in Type II Pipkin's fractures. In such a way the correct and stable anatomic joint is restored allowing an early mobilization necessary in articular joint fractures.