An Unusual Variant of Pipkin's Fracture Dislocation of Hip: A Case Report

Abstract

Introduction: Injuries of the hip joint from pure hip dislocations to fracture dislocations have been described and classified by various authors. These descriptions do not include fracture dislocation of hip associated with fracture of the greater trochanter.

Case report: We report an unusual case of fracture dislocation of hip in which posterior dislocation of hip was associated with fracture of acetabulum, femoral head, femoral neck, greater trochanter and ipsilateral shaft of tibia. The fracture dislocation was managed with open reduction and internal fixation. Such fracture dislocation has not been reported in literature to the best of our knowledge.

Conclusion: We believe that fracture dislocations associate with fractures of greater trochanter should be included in current classification systems of fracture dislocations of hip.

Keywords: Hip dislocation; acetabulum fracture; femoral head fracture; femoral neck fracture; greater trochanter fracture.

Figure 1

Antero- posterior radiograph of hip: posterior dislocation of hip associated with fracture of acetabulum, femoral head, femoral neck, greater trochanter

Figure 2

Axial image CT scan

Figure 3

Immediate post operative radiograph: open reduction and internal fixation of acetabular, femoral neck and greater trochanter component

Figure 4

Follow up X-ray antero-posterior and lateral view at at 3 years showing good fracture union without any sign of osteonecrosis of femoral head or heterotrophicossification