Arthroscopic Fragment Excision of Pipkin Type I Displaced Femoral Head Fracture: A Case Report

Che Keun Kim; Woo Chull Chung; Ji Hun Song; Jin Young Park; Bo Hyun Jung

doi:10.5371/hp.2014.26.1.36

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Kim, Chung, Song, Park, and Jung: Arthroscopic Fragment Excision of Pipkin Type I Displaced Femoral Head Fracture: A Case Report

Case Report

Hip & Pelvis 2014; 26(1): 36-40.

Published online: 31 March 2014

DOI: https://doi.org/10.5371/hp.2014.26.1.36

Arthroscopic Fragment Excision of Pipkin Type I Displaced Femoral Head Fracture: A Case Report

Che Keun Kim, MD, Woo Chull Chung, MD, Ji Hun Song, MD, Jin Young Park, MD, Bo Hyun Jung, MD

Department of Orthopaedic Surgery, St. Carollo Hospital, Suncheon, Korea.

Address reprint request to Woo Chull Chung, MD. Department of Orthopaedic Surgery, St. Carollo Hospital, 221 Sungwang-ro, Suncheon 540-719, Korea. TEL: +82-61-720-2404, FAX: +82-61-720-6104, wctoilets@hanmail.net

Received 15 January 2014 Revised 8 March 2014 Accepted 10 March 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There has been a variety of options for treatment of femoral head fracture with hip dislocation according to the Pipkin classification. Pipkin type I fractures with minimal displacement have been treated conservatively. However, in cases where the fracture was displaced or reduced incongruently, it has been treated by open fragment excision or fixation after reduction. In our case, the patient was a 62-year-old man who sustained a displaced fracture of Pipkin type I. We achieved a satisfactory outcome by arthroscopic excision of a displaced bony fragment and small bony fragments that could not be confirmed by pre-operative imaging study. Therefore, we report on the case with a review of the literature.

Keywords: Displaced femoral head fracture, Pipkin type I, Arthroscopic excision

Figures and Tables

Fig. 1

(A) The right hip was dislocated posteriorly and femoral head fracture was seen. (B) Closed reduction was done. But femoral head fragment (arrow) was displaced reversely. (C) Computed tomographic image of the right hip showed reversely displaced femoral head fragment.

Fig. 2

(A) Avulsion bony fragment with ligamentum teres (asterisk) was seen. (B) It was excised. (C) In peripheral portion, there was a large bony fragment. (D) The bone fragment was too large to be removed through portal, so we decide to crush the fragment to pieces by awl. (E, F) After removal, there was no any other fragment.

Fig. 3

The bony fragments was removed.

Fig. 4

Six months later, the right hip joint congruency was acceptable and the patient had no pain in walking.

References

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