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Updated: Jul 16, 2026
Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
[Fractures of the femoral head. A multicenter study]
S Lederer1, M Tauber, S Karpik
1Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Paracelsus Medizinische Universität, Salzburger Landeskliniken, Müllner Hauptstrasse 48, A-5020 Salzburg. S.Lederer@salk.at
Insights
Pipkin fractures, rare femoral head injuries, show varying outcomes based on type and treatment. Anatomical reconstruction is crucial for optimal results in these dislocated hip fractures.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Hip Joint Biomechanics
Background:
- Dislocated femoral head fractures (Pipkin fractures) are rare injuries.
- A multicenter study evaluated patients treated in Austrian trauma centers.
- Focus on fracture types, treatment strategies, and long-term outcomes.
Purpose of the Study:
- Evaluate Pipkin fracture types.
- Assess treatment modalities.
- Determine long-term functional and radiological outcomes.
Main Methods:
- 46 patients with Pipkin fractures included.
- Personal and radiological follow-up examinations performed.
- Fractures classified using the Pipkin classification system.
Main Results:
- Type I fractures yielded the best functional outcomes (Harris Hip Score), followed by Types II, IV, and III.
- Conservative treatment or fragment excision correlated with lower arthrosis grades.
- Open reduction and internal fixation resulted in poorer radiological outcomes.
- 24% of patients required total hip prosthesis implantation.
- No significant soft tissue calcification observed.
Conclusions:
- Fracture fragment size and location significantly impact patient outcomes.
- Precise anatomical reconstruction of the femoral head, particularly the weight-bearing surface, is essential.
Background:
Dislocated fractures of the femoral head are highly infrequent injuries. In line with this multicenter study, a follow-up examination of patients with Pipkin fractures was performed in Austrian trauma centers. The aim of this study was to evaluate the types of fractures, the kind of treatment, and the long-term results.
Patients And Methods:
In sum 46 patients were included in our study. A personal and radiological follow-up examination was carried out. The fractures were classified according to Pipkin.
Results:
Patients with type I fractures had the best functional outcome according to the Harris Hip Score, followed by patients with type II fractures, type IV fractures, and finally type III fractures. The result of the radiological follow-up examination showed that patients who were treated conservatively or with extirpation of the fragment had a lower grade of arthrosis. The poorest radiological outcome was seen in patients who underwent surgical treatment with open reduction and internal fixation. The implantation of a total hip prosthesis was necessary in 24% of the patients. A relevant soft tissue calcification was not recorded.
Conclusion:
The size and location of the fractured fragment has a huge influence on the outcome. An exact anatomical reconstruction of the femoral head, especially of the weight-bearing part, is absolutely necessary.
