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Review

Surgical Approaches for Managing Femoral Head Fractures (FHFs); What and How to Choose from the Different Options?

ORCID Icon, & ORCID Icon
Pages 133-145 | Published online: 23 Apr 2022

Figures & data

Figure 1 Pipkin classification of femoral head fractures. Type I: Fracture below fovea, Type II: Fracture above fovea, Type III: Type I or II with an associated femoral neck fracture, and Type IV: Type I or II with associated acetabular fracture.

Figure 1 Pipkin classification of femoral head fractures. Type I: Fracture below fovea, Type II: Fracture above fovea, Type III: Type I or II with an associated femoral neck fracture, and Type IV: Type I or II with associated acetabular fracture.

Figure 2 Demonstration of the suggested approaches for the management. (A) Medial approach to the hip. (B) Anterior, anterolateral, lateral, and posterior approaches. (C) Hip arthroscopy. (D) Surgical hip dislocation (SHD).

Figure 2 Demonstration of the suggested approaches for the management. (A) Medial approach to the hip. (B) Anterior, anterolateral, lateral, and posterior approaches. (C) Hip arthroscopy. (D) Surgical hip dislocation (SHD).

Figure 3 Example flow chart showing how to select the most appropriate approach for femoral head fractures (FHFs) surgical management as per Pipkin classification (Type I: Fracture below fovea, Type II: Fracture above fovea, Type III: Type I or II with an associated femoral neck fracture, and Type IV: Type I or II with associated acetabular fracture). * The mentioned approaches could be used for either fragment fixation or excision, ** better to avoid a posterior approach to preserve the blood supply.

Abbreviations: ORIF, open reduction and internal fixation; THA, total hip arthroplasty.
Figure 3 Example flow chart showing how to select the most appropriate approach for femoral head fractures (FHFs) surgical management as per Pipkin classification (Type I: Fracture below fovea, Type II: Fracture above fovea, Type III: Type I or II with an associated femoral neck fracture, and Type IV: Type I or II with associated acetabular fracture). * The mentioned approaches could be used for either fragment fixation or excision, ** better to avoid a posterior approach to preserve the blood supply.