Fractures of the femoral head are intraarticular. They may be associated with hip dislocations, acetabular fractures, or femoral neck fractures.
In split fractures (Pipkin) there is a fragment which has split off from the femoral head.
The optimal treatment strategy is not clear. Only anatomical reduction of the fracture fragments gives good long-term results. The treatment should therefore be focused on restoration of the articular surface, combined with treatment of any associated injuries.
Osteochondral fragments cranial to the ligamentum teres are usually part of the weight-bearing surface, making anatomical reduction mandatory.