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Safe Surgical Dislocation for Femoral Head Fractures

March 01, 2017

Contributors: Bhupesh Karthik Balasubramanyan; Hitesh Gopalan, MS; Parthasarathy Srinivasan; Naveen Tummala, MS ; Ashok Sunil Gavaskar Kumaresan, MS; Ashok Sunil Gavaskar Kumaresan, MS

2017 AWARD WINNER Femoral head fractures are high-energy injuries often associated with posterior hip dislocation. Surgical treatment is recommended in patients with an incongruent or unstable hip joint after closed reduction. Safe surgical dislocation has emerged as the approach of choice for the management of these injuries. The approach provides circumferential exposure of the femoral head and acetabulum to address fractures and labral injuries without an increased risk of avascular necrosis of the femoral head. Sound knowledge of the vascular supply to the femoral head, meticulous posterior soft-tissue dissection, and precise osteotomy technique are imperative to avoid iatrogenic injury to the femoral head blood supply. This surgical technique video explains the anatomic basis, key landmarks, and techniques for performing a safe surgical dislocation in a patient with a Pipkin type II fracture-dislocation.

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