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- Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review
- Nazim Sifi, Ryad Bouguenna
- J Trauma Inj. 2024;37(2):161-165. Published online June 17, 2024
- DOI: https://doi.org/10.20408/jti.2024.0004
- 2,796 View
- 69 Download
- 1 Web of Science
- 1 Citations
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Abstract
PDF - Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.
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Citations
Citations to this article as recorded by
- Pipkin fractures: fracture type-specific management
Axel Gänsslen, Richard A. Lindtner, Dietmar Krappinger, Jochen Franke
Archives of Orthopaedic and Trauma Surgery.2024; 144(10): 4601. CrossRef
- An Irreducible Hip Dislocation with Femoral Head Fracture
- Tae-Seong Kim, Chang-Wug Oh, Joon-Woo Kim, Kyeong-Hyeon Park
- J Trauma Inj. 2018;31(3):181-188. Published online December 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.026
- 10,713 View
- 189 Download
- 2 Citations
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Abstract
PDF
Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.
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Summary
Citations
Citations to this article as recorded by- Traumatic Bilateral Asymmetrical Hip Dislocation with Acetabular Fracture: A Case Report and Review of Current Evidence
Jovana Grupkovic, Uros Dabetic, Nikola Bogosavljevic, Dejan Aleksandric, Mladen Milanovic, Dunja Savicevic, Slavisa Zagorac
Life.2025; 15(4): 532. CrossRef - Safety and efficacy of surgical hip dislocation in managing femoral head fractures: A systematic review and meta-analysis
Ahmed A Khalifa, Mohamed A Haridy, Ali Fergany
World Journal of Orthopedics.2021; 12(8): 604. CrossRef
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