Femoral head fractures (lower extremity)

A 64-year-old female was involved as a passenger in a high-speed motor vehicle accident while on vacation in Nicaragua.

She was taken to a local hospital and diagnosed with a right-sided posterior hip dislocation that was closed reduced. She also had an associated right-sided Pipkin IV Type fracture of the femoral head with associated Posterior Wall Type fracture of the acetabulum.

After placement of skeletal traction she was transferred to us through a medical flight facilitated through her travel insurance. Open reduction and internal fixation (ORIF) was performed through a Kocher-Langenbeck surgical approach with an anterior surgical hip dislocation.

The Posterior Wall fracture was reduced and fixed with one-third tubular and pelvic reconstruction plates and screws. The femoral head fracture was reduced and fixed with sub-articular screws and preservation of the blood supply, reduction, hip stability, and adequate hardware placement was confirmed.

At the time of her latest follow-up at 5 months radiographs reveal healed acetabular and femoral head fractures and maintenance of reduction with mild degenerative changes in the hip joint.

  • Figure A

    Figure A

    X-Rays (top) revealing a right-sided Pipkin IV femoral head fracture and associated Posterior Wall acetabular fracture (yellow arrows) and CT-Scan images (bottom) further delineating the fracture patterns (femoral head fracture is indicated with grey arrows).


  • Figure B

    Figure B

    Preoperative plan (left) and post-operative CT-Scan images (right) 1 day following ORIF.


  • Figure C

    Figure C

    Radiographs at 5-months post-operative revealing healed femoral head and acetabular fractures.



Our Patients

  • “The level of expertise and care is beyond imagination. Dr. Helfet is an artist.”

    ~ Herve Duteil

    Read Full Story

  • “We never would have gotten through this without HSS.”

    ~ Robert Casale

    Read Full Story

  • “They were able to piece me back together where others were not.”

    ~ J. D. Pelaez

    Read Full Story

  • “There was the possibility for the first time to live a full and adventurous life that I had always dreamed of.”

    ~ Devon Reynolds

    Read Full Story

  • “The entire hospital staff were just amazing from the instant we rolled through the doors throughout the entire stay.”

    ~ Victor Katz

    Read Full Story

  • “Being an international patient, the welcome in that department was like home!”

    ~ Cecilia Chlimper de Batievsky

    Read Full Story

  • “I was able to return to my passion, which was skiing big mountains.”

    ~ Tim DiPietro

    Read Full Story

David L. Helfet, MD

535 East 70th Street
New York, NY 10021

212-606-1888 phone
212-628-4473 fax

New York Fracture Care

Contact Us

David L. Helfet, MD 

Dean G. Lorich, MD

David S. Wellman, MD