Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and
coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus
osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and
coxa valga also underwent closed reduction initially and then continued
conservative treatment. After eight weeks, when she started gait training, progressive
pain became symptomatic. Persistent hip
pain at weight bearing was not improved in spite of arthroscopic
synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus
osteotomy was indicated and her
refractory pain was resolved gradually. We suggest that femoral varus
osteotomy should be considered for superolateral subluxation associated
fracture dislocation of the hip in Pipkin type-IV and
coxa valga.