Alternativas terapéuticas en la fractura luxación de la cabeza femoral

Abstract

Fractures of the femoral head associated with a hip dislocation are relatively rare and occur as a consequence of high-energy trauma. According to the literature, fractures of the femoral head represent 7 to 16% of all fractures hip dislocation. 1-2
The treatment of these dislocation fractures depends exclusively on the fracture tract, as well as if there are associated injuries. The treatment can be conservative or surgical depending on the type of fracture. In 1957 Garret Pipkin described a classification for fractures of the femoral head, which ranges from type I to type IV, depending on the level of fracture and associated injuries.

The purpose of the present work is to demonstrate the therapeutic alternatives in fractures dislocation of the femoral head, as well as their prognosis. Here we present a series of three cases attended at the San Agustin Clinical Hospital, in a period of 5 years with a diagnosis of fracture dislocation of the femoral head type Pipkin I and IV, with different treatments, as well as its evolution in a period of follow-up not less than 6 months.

We were able to conclude that although the luxation fracture of the femoral head is a rare pathology, we should be familiar with the correct diagnosis and treatment of each of its types. The reduction of the dislocation fracture should be anatomical and avoid further injury of the soft tissues with the treatment. In some cases the reduction of the dislocation is usually sufficient, however if there are fragments larger than 1 cm2 or with fragments in the joint, the removal of the fragment or its open reduction internal fixure ORIF is recommended.