Pipkin IV fracture dislocation of the hip in a football athlete - A case report

Abstract

Pipkin type IV fracture dislocation of the hip is a rare, high-energy injury, that is associated with poor functional outcomes and complications. We report a case of a 20-year old male quarterback who sustained a Pipkin type IV fracture dislocation during a football game. He underwent immediate closed reduction, transfer to a Level I trauma centre, surgical management, and progressive rehabilitation. Clinical and radiographic assessments were carried out periodically for 1 year. At 10 months post-injury, the athlete returned to full-time play as the starting quarterback of his University football team. He completed a pain-free season at 1-year post-injury. Clinical and radiographic evaluations demonstrated appropriate healing with no complications. Despite the high-energy and often devastating nature of Pipkin Type IV injuries, this case report demonstrates that prompt, appropriate management and rehabilitation of this injury in a University quarterback led to positive functional outcomes. Further studies on the treatment and outcomes of this rare sport injury are needed to optimize management.

Keywords: Case report; Football injury; Fracture dislocation of hip; Pipkin IV; Sport injury.

Fig. 1

AP and lateral X-rays demonstrating posterior fracture dislocation of the right hip.

Fig. 2

Axial, coronal and lateral select CT cuts of the pelvis post right hip reduction.

Fig. 3

AP and Judet views of the pelvis at 2 weeks post-op demonstrating congruent right hip joint and hardware in place.

Fig. 4

AP and Judet views of the pelvis at 4 months post-op demonstrating well-reduced right hip joint, maintained hardware, mild heterotopic ossification, and no evidence of avascular necrosis of the femoral head.