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Trauma
intermediate
X-Type

Femoral Head Fractures (Pipkin Classification)

Hip Trauma

A 28-year-old male is brought to the emergency department after a motor vehicle collision (dashboard injury). He presents with his right hip flexed, adducted, and internally rotated, with severe pain and inability to move his leg. AP pelvis radiograph confirms a posterior hip dislocation. Closed reduction is achieved successfully within 4 hours in the operating room under general anesthesia. Post-reduction CT reveals a femoral head fracture with a fragment involving 35% of the weight-bearing dome superior to the fovea. There is no associated femoral neck or acetabular fracture. Regarding this injury pattern:

Mark each as TRUE or FALSE

A

The fovea capitis serves as the critical anatomical landmark in Pipkin classification, with fracture...

B

The 6-hour window for hip dislocation reduction is critical, with AVN rates increasing from 10-15% i...

C

An anterior (Smith-Petersen) surgical approach is preferred for ORIF of femoral head fractures follo...

D

Pipkin Type III fractures (femoral head fracture with associated femoral neck fracture) have the bes...

E

Post-reduction CT is mandatory for all hip dislocations to assess fragment size/location, identify l...

Answer the questions to see explanations

Click T (True) or F (False) for each option