Pipkin fracture is defined as:
B i.e Posterior dislocation is common Posterior Dislocation Of Hip It is most common type of hip dislocation in adults and childrenQ. Usually this occurs in a road accident when someone seated in car is thrown forwards, striking the knee against the dashboard (dashboard injuryQ). It is the position (direction) of hip at the time of injury that decided the pattern of injury. Position of Hip at the time of Injury Patter of Injury Flexion, adduction, internal rotation Pure posterior dislocation Less flexion, less adduction (neutral or slight abduction), internal rotation Posterior fracture dislocation Hyper abduction + Extension Anterior dislocation Classification Schemes For Posterior Hip Dislocations Thompson & Epstein Type I Dislocations without or with minor fracture Type II Dislocation with a single large fracture of posterior acetabular rim. Type III Dislocation with comminution of posterior acetabular rim. Type IV Dislocation with fracture of acetahular floor. Type V Dislocation with fracture of femoral headQ Stewa And Miford Type I Dislocation without fracture Type II Dislocation with posterior rim fracture (one or more fragments), but the hip is stable after reduction Type III Dislocation with fracture of rim producing gross instability Type IV Dislocation with fracture head or neck of femur So in other words Thompson & Epstein, and Stewa & Milford are posterior dislocation injuries of hip and Pimpkin's fracture is fracture of femoral headQ (& / or neck) in posterior dislocation injuries. In posterior dislocation of hip clinical presentation is - Flexion, adduction and internal (medial) rotation deformity with shoeningQ Femoral head can be palpated posteriorly - Vascular sign of Narath is positiveQ i.e. due to posterior dislocation of hip joint the vessels fall back unsuppoed so femoral aerial pulsation, which is felt against the head of the femur will be feeble or even may not be palpable . - Due to posterior direction of displacement sciatic nerveQ and superior gluteal aery injury may occur. - It is the posterior dislocation that cause maximum shoening of limbo and is most commonly associated with sciatic nerve injuryQ Simple dislocations are mostly managed by close reduction under anesthesiaQ. Few methods of reduction are - Stimsons gravity method, Allis maneuver, Bigelow maneuver and East Baltimore lift.
Head of radius fracture
Head of femur fracture
Fracture dislocation of ankle
Fracture neck of femur