Retrospective series of 7 patients (out of 72 femoral head fracture-dislocations over 6 years) with a specific injury variant: irreducible femoral head fracture-dislocation WITHOUT posterior wall acetabular fracture. The study defines the clinical and radiographic hallmarks that distinguish this pattern, describes a uniform operative strategy, and reports complications.
When you see a post-traumatic hip in fixed flexion and neutral rotation (not adducted/internally rotated) with a femoral head fragment in the acetabulum and NO posterior wall fracture on CT, recognize this as an irreducible variant — do not attempt closed reduction, as it risks iatrogenic femoral neck fracture; take the patient urgently to the OR via Smith-Petersen approach, because delay beyond 8 hours correlates with AVN.
Retrospective series of 7 patients (out of 72 femoral head fracture-dislocations over 6 years) with a specific injury variant: irreducible femoral head fracture-dislocation WITHOUT posterior wall acetabular fracture. The study defines the clinical and radiographic hallmarks that distinguish this pattern, describes a uniform operative strategy, and reports complications.
When you see a post-traumatic hip in fixed flexion and neutral rotation (not adducted/internally rotated) with a femoral head fragment in the acetabulum and NO posterior wall fracture on CT, recognize this as an irreducible variant — do not attempt closed reduction, as it risks iatrogenic femoral neck fracture; take the patient urgently to the OR via Smith-Petersen approach, because delay beyond 8 hours correlates with AVN.