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            [0] => Management of Irréductible Pipkin II Femoral Head Dislocation Fracture: A Case Report  and a review of the literature
        )

    [etablissement] => Array
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            [0] => Mohamed kassab orthopedics institute (Adults departement)
        )

    [nom] => Array
        (
            [0] => Saadi
        )

    [prenom] => Array
        (
            [0] => Chedi
        )

    [email] => Array
        (
            [0] => chedisaadi@gmail.com
        )

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            [0] => 55753111
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            [0] => 
 
Nom prénom / Name Surname: Chedi Saadi
Email: chedisaadi@gmail.com
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

 
Nom prénom / Name Surname: Mehdi Meddeb
Email: meddeb1mehdi@gmail.com
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

 
Nom prénom / Name Surname: Oussema Ben mohamed
Email: Oussama_benmohamed@hotmail.fr
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

 
Nom prénom / Name Surname: Montassar Ayechi
Email: ayachi4422@gmail.com
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

 
Nom prénom / Name Surname: Khalil Habboubi
Email: Khalil.habboubi@gmail.com
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

 
Nom prénom / Name Surname: Mondher Mestiri
Email: mestirimondher@yahoo.fr
Hôpital / Hospital: Mohamed kassab orthopedics institute (Adults departement)

        )

    [mots_cles] => Array
        (
            [0] => Dislocation Fracture;
Femoral Head;
Irréductible;
Management;

        )

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            [0] => 3663
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            [0] => 1
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    [user_email] => Array
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            [0] => chedisaadi@gmail.com
        )

    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction:
Fractures of the femoral head during hip dislocations are rare, especially when they are irreducible. This situation poses a serious risk to the functional prognosis of the hip. Treatment proves to be complex. We present a case of an irreducible Pipkin II type femoral head dislocation-fracture.

Case report:
This concerns a 34-year-old male patient, a teacher  with no significant medical history, who sought medical attention for a closed right hip trauma following a road traffic accident. The clinical examination, conducted 3 hours after the accident, revealed a conscious and stable patient on hemodynamic and respiratory fronts. The musculoskeletal examination revealed a right lower limb in a deviated position, with no sciatic nerve deficit. Radiological assessment confirmed the diagnosis of a posterior dislocation-fracture of the femoral head, classified as Pipkin II. An attempt at reduction under general anesthesia, performed 5 hours post-trauma, was unsuccessful. The patient was approached posterior-laterally. Exploration revealed a femoral head dislocated posteriorly, with a trapped cephalic fragment in the acetabulum attached to the round ligament. Reintroduction of the femoral head was challenging due to a buttonhole effect of the capsule, but it was eventually reduced after several cautious attempts. Osteosynthesis of the antero-inferior fragment was performed using two antegrade cannulated Herbert screws. Repair of the posterior capsular gap was also carried out. The patient underwent traction for three weeks, with weight-bearing initiated in the sixth week. After a 12-month follow-up, the functional result was assessed as good according to the PMA score, and no radiological abnormalities were observed.

Conclusion:
Irreducible femoral head dislocation fractures are a rare entity that always requires surgical treatment. The principle is to preserve the femoral head. Lag screw fixation allows for the preservation of the blood supply to the round ligament. Nevertheless, long-term arthritic progression appears inevitable.
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