Femoral head fractures are relatively uncommon and are typically associated with hip dislocations after severe high-impact trauma such as a motor vehicle collision. Hip fracture-dislocations are clinical emergencies requiring immediate reduction to prevent osteonecrosis.
Pipkin classification: Classification system for femoral head fractures usually in association with hip dislocations.
- Type I: Femoral head fracture inferior (distal) to fovea. Usually small fracture not involving the weight-bearing surface
- Type II: Femoral head fracture superior (proximal) to fovea. Larger fracture involving the weight-bearing surface
- Type III: Type I/II femoral head fracture AND fracture of femoral neck. Increased risk of avascular necrosis
- Type IV: Type I/II femoral head fracture AND fracture of acetabulum, most commonly the posterior wall
- 1957 – Pipkin classification – 4 Types
- 1987 – Brumback classification – 5 Types
- Garrett Pipkin (1904-1981)
- Pipkin G. Treatment of grade IV fracture-dislocation of the hip. J Bone Joint Surg Am. 1957 Oct;39-A(5):1027-42 [PMID 13475403]
- Brumback RJ, Kenzora JE, Levitt LE, Burgess AR, Poka A. Fractures of the femoral head. Hip. 1987:181-206. [PMID 3546215]
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