Surgical Dislocation With Trochanteric Flip Osteotomy

The imaging described is of a femoral head fracture with an associated acetabular fracture, otherwise known as a pypkin 4. Surgical dislocation with the trochanteric flip osteotomy provides access to the Femoral head and posterior wall while preserving the blood supply to the femoral head. 11 of 12 patients healed their femoral head fractures; one patient or 8.3% developed osteonochrosis. A Smith-Peterson approach provides good access to the fem oral head but not to the posterior wall.