Femoral Head Fracture in an Adult Patient with Isolated Posterior Labrum Avulsion Recognized Through the 'fleck' Sign: Technical Tips

Overview

Journal J Hip Preserv Surg

Publisher Oxford University Press

Date 2019 May 10

PMID 31069100

Authors

Maroun Rizkallah

Marwan Haddad

Gaby Haykal

Affiliations

Soon will be listed here.

Abstract

Femoral head fractures in adults are known to be frequently associated with femoral neck fractures, acetabular fractures and sciatic nerve neurapraxia. Here, we report for the first time in the English medical literature the case of a 30-year-old patient having a Pipkin Type II comminuted femoral head fracture associated to an isolated acetabular labral osteochondral avulsion. This entity was diagnosed preoperatively through the presence of the acetabular 'fleck' sign recently described in adolescents with hip dislocation. This was of paramount importance knowing the key role of the acetabular labrum in physiological hip functioning. Therefore, a high index of suspicion of complete posterior acetabular labrum avulsion should be raised in front of a hip computed tomography scan showing the acetabular fleck sign even in an adult patient. This finding is important in posing the surgical indication and in completing the preoperative surgical planning in cases of femoral head fractures and dislocations.

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