Pipkin fracture - type IV

Case contributed by Mohammad Farghali Ali Tosson
Diagnosis certain

Presentation

Post-traumatic.

Patient Data

Age: 50 years
Gender: Male
ct

Left femoral head is incompletely reduced and superiorly displaced, with anterolateral fracture and multiple small intraarticular hip joint fracture fragments, associated with acetabular wall fractures and surrounding hematoma.

No femoral neck fracture.

Case Discussion

Pipkin IV fracture of the left femoral head.

Classification

  • type I: fracture distal to the fovea capitis, a small fracture not involving the weight-bearing surface

  • type II: fracture proximal to the fovea capitis, a large fracture involving the weight-bearing surface

  • type III: type I or II fracture with a fracture of the femoral neck, has an increased risk of avascular necrosis

  • type IV: type I or II fracture with a fracture of the acetabular wall, usually the posterior wall

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