{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:18:14Z","timestamp":1784557094941,"version":"3.55.0"},"reference-count":52,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:p>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>The smaller the head fragment, the more likely it is located at the bottom and in front of the femoral head, which then determines the most suitable approach.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>A CT scan is essential after reduction and before resumption of weight-bearing to verify the size and congruence of the fragments and whether there are foreign bodies and\/or a fracture of the posterior wall.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Classifications should include the size of the fragment and whether or not there is an associated fracture of the acetabulum or femoral neck (historical \u2018Pipkin\u2019, modernised \u2018Chiron\u2019).<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>In an emergency, the dislocation should be rectified, without completing the fracture (sciatic nerve palsy should be diagnosed before reduction). A hip prosthesis may be indicated (age or associated cervical fracture).<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Delayed orthopaedic treatment is sufficient if congruence is good. A displaced fragment can be resected (foreign bodies and \u00bc head), reduced and osteosynthesised (\u2153 and \u00bd head), and a posterior wall fracture reduced and osteosynthesised. Small fragments can be resected under arthroscopy. The approach is medial (Luddloff, Ferguson, Chiron) to remove or osteosynthesise \u2153 or \u00bc fragments; posterior for \u00bd head or a fractured posterior wall.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The results remain quite good in case of resection or an adequately reduced fragment. Long-term osteoarthritis is common (32%) but well tolerated with a low rate of prosthetisation. Avascular necrosis remains a possible complication (8.2%). Sciatic nerve palsy (4% of fracture dislocations) is more common for dislocations associated with posterior wall fractures.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1530\/eor-22-0041","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T07:47:21Z","timestamp":1653983241000},"page":"375-383","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":11,"title":["Dislocation fracture of the femoral head in adult"],"prefix":"10.1530","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-0288","authenticated-orcid":true,"given":"Philippe","family":"Chiron","sequence":"first","affiliation":[{"name":"Orthop\u00e9die Traumatologie, Secteur A, Batiment riquet, \u00e9tage 5, CHU Toulouse, Toulouse Cedex 9, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Reina","sequence":"additional","affiliation":[{"name":"Orthop\u00e9die Traumatologie, Secteur A, Batiment riquet, \u00e9tage 5, CHU Toulouse, Toulouse Cedex 9, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"issue":"1 S","key":"bib1","series-title":"Orthopaedics and Traumatology, Surgery and Research","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1016\/j.otsr.2012.11.007","article-title":"Fracture-dislocations of the femoral head","volume":"99","author":"Chiron","year":"2013","unstructured":"Chiron PLafontan VReina N. 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