Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review
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....
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2024-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2024-0004.pdf |
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| author | Nazim Sifi Ryad Bouguenna |
| author_facet | Nazim Sifi Ryad Bouguenna |
| author_sort | Nazim Sifi |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-58fa6a86c8b6411486d93d882906265c |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-58fa6a86c8b6411486d93d882906265c2025-01-16T06:10:17ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-06-0137216116510.20408/jti.2024.00041310Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature reviewNazim Sifi0Ryad Bouguenna1 Orthopaedic and Trauma Surgery Unit, EPH Beni Abbes, Beni Abbes, Algeria Orthopaedic and Trauma Surgery Unit, EPH Beni Abbes, Beni Abbes, AlgeriaFemoral 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.http://jtraumainj.org/upload/pdf/jti-2024-0004.pdfhip dislocationfemoral head fracturepipkin classificationwatson-jones approachcase reports |
| spellingShingle | Nazim Sifi Ryad Bouguenna Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review Journal of Trauma and Injury hip dislocation femoral head fracture pipkin classification watson-jones approach case reports |
| title | Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review |
| title_full | Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review |
| title_fullStr | Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review |
| title_full_unstemmed | Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review |
| title_short | Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review |
| title_sort | relevance of the watson jones anterolateral approach in the management of pipkin type ii fracture dislocation a case report and literature review |
| topic | hip dislocation femoral head fracture pipkin classification watson-jones approach case reports |
| url | http://jtraumainj.org/upload/pdf/jti-2024-0004.pdf |
| work_keys_str_mv | AT nazimsifi relevanceofthewatsonjonesanterolateralapproachinthemanagementofpipkintypeiifracturedislocationacasereportandliteraturereview AT ryadbouguenna relevanceofthewatsonjonesanterolateralapproachinthemanagementofpipkintypeiifracturedislocationacasereportandliteraturereview |