Hussain Alyousif1, Hasan Aleisawi2, Hussain Alkaff1, Nora Albusayes1. 1. Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Saudi Arabia. 2. Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Saudi Arabia. Electronic address: alanazihasan@gmail.com.
Abstract
INTRODUCTION: Pipkin-III femoral head fracture dislocation is a rare injury and its outcome is guarded. Some authors believe femoral neck fracture of Pipkin-III injury is largely iatrogenic. Recent literature showed none of these injuries had excellent outcome, and most patients end up with hip replacement. PRESENTATION OF CASE: A 34-year-old man sustained a traumatic hip injury with fracture-dislocation and an iatrogenic femoral neck fracture during reduction. A modified Gibson approach was performed to reduce and fix the femoral head and neck fractures in a retrograde fashion. Follow-up at 26 months assessment showed viable femoral head, and excellent functional outcome. DISCUSSION: Iatrogenic femoral neck fracture in the setting of femoral head dislocation is not uncommon. Clinical and radiological signs of irreducible dislocation can easily be missed which might lead to devastating complications like iatrogenic femoral neck fracture. Recognition of this unique injury, timely intervention, and meticulous dissection might positively alter the patient's outcome. CONCLUSION: This case serves to enlighten orthopedists about the risk of iatrogenic femoral neck fracture, methods to avoid such complication, and the proper management.
INTRODUCTION: Pipkin-III femoral head fracture dislocation is a rare injury and its outcome is guarded. Some authors believe femoral neck fracture of Pipkin-III injury is largely iatrogenic. Recent literature showed none of these injuries had excellent outcome, and most patients end up with hip replacement. PRESENTATION OF CASE: A 34-year-old man sustained a traumatic hip injury with fracture-dislocation and an iatrogenic femoral neck fracture during reduction. A modified Gibson approach was performed to reduce and fix the femoral head and neck fractures in a retrograde fashion. Follow-up at 26 months assessment showed viable femoral head, and excellent functional outcome. DISCUSSION: Iatrogenic femoral neck fracture in the setting of femoral head dislocation is not uncommon. Clinical and radiological signs of irreducible dislocation can easily be missed which might lead to devastating complications like iatrogenic femoral neck fracture. Recognition of this unique injury, timely intervention, and meticulous dissection might positively alter the patient's outcome. CONCLUSION: This case serves to enlighten orthopedists about the risk of iatrogenic femoral neck fracture, methods to avoid such complication, and the proper management.