Irreducible Brumback IV femoral head fractures: Is Smith-Petherson approach the best choice?report of two cases

Femoral head fracture-dislocations are rare، while irreducible cases are even less frequent. Truly irreducible fractures such as the two cases in this report must be differentiated from incomplete reduction due to incarcerated bone or soft tissue interposition. Opinions vary on the surgical approach to be used once the hip is reduced and the fragment of the femoral head yet remains to be stabilized. The smith-peterson approach with the patient in the supine position provides a direct anterior view of the fracture site.

We reported two cases of Brumback-type 4، who were treated with this approach. Postoperatively we allowed weight-bearing after 3 months. After 14 and 10 months they had good results.

It seemed that Smith-Petherson approach was a good choice for this type of injuries.