A rare case of an irreducible Pipkin II fracture–dislocation of the femoral head in a young patient following low-energy trauma

INTRODUCTION: Fractures–dislocations of the femoral head are rare, and irreducible dislocations are even rarer. The functional prognosis is poor. PRESENTATION OF CASE: We report the case of a 23-year-old male brought to the emergency room following low-energy trauma. X-rays and a computed tomography scan revealed a Pipkin II fracture–dislocation of the right femoral head. We attempted reduction with the patient under general anesthesia; this failed, so we proceeded to total hip arthroplasty (THA). DISCUSSION: A femoral head fracture has a poor prognosis; the principal complications are osteonecrosis, osteoarthritis, and heterotopic ossifications. No surgical treatment algorithm for a femoral head fracture (for fragment excision, followed by internal fixation or THA) is available, given the rarity of the injury and the lack of sufficient cases. CONCLUSIONS: We describe the mechanism of low-energy injury, as well as the controversial THA treatment chosen by this young patient.