Management of pipkin type 3 fracture-dislocation in young adults: A dilemma

Abstract

Pipkin type 3 fracture-dislocation constitutes a rare subgroup of fractures involving the femoral neck and head fracture. The management is difficult and controversial, including osteosynthesis using Herbert or cancellous screws and hip replacement surgery. In this case report, a 26-year-old male suffered a road traffic accident leading to a hip fracture. Radiographs and computed tomography scan of the hip depicted three large fragments of the femur head, dislocated posteriorly along with the neck of femur fracture. Considering the needs of the patient, fracture morphology, and unpredictable results of the osteosynthesis, the patient was treated primarily with uncemented total hip replacement. The complexity of the fracture leads to more chances of malreduction and avascular necrosis of the femur head. The patient had an uneventful intra and postoperative period. At the 3-year follow-up, the patient was walking unaided, pain-free, and performing all the activities of daily living satisfactorily.