Pipkin Type III Fracture-Dislocation as a Terrible Triad of the Hip

Features of a Pipkin Type III fracture:

(1) posterior hip dislocation

(2) fracture of the femoral head

(3) fracture of the femoral neck

The fracture of the femoral neck is often iatrogenic, occurring while trying to reduce the dislocation.

Complications include avascular necrosis of the femoral head.

Many patients eventually require a total hip replacement.

The outcome can be improved by doing the following during initial management:

(1) early recognition that the dislocation is irreducible (based on clinical and radiologic findings)

(2) timely surgery with a meticulous dissection and ORIF