Clinical results of femoral head fracture-dislocation treated according to the Pipkin classification

Yu, Xiao; Pang, Qiuxiang; Chen, Xian-Jun

doi:10.12669/pjms.333.12633

Cited by 24 publications

(17 citation statements)

References 16 publications

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“…Although a statistical difference was not found (P= 0.59), the non-operative intervention seems to result in better outcome than an operative intervention. Several studies support this non-operative management of Pipkin I fractures and controversies remain regarding surgical management of these fractures [30][31][32][33] . The fact that only 4 cases were managed non-operative, our nding could be attributed to statistical error.…”

Section: Discussionmentioning

confidence: 92%

Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors

Shakya

Sun

Xiang

2021

Preprint

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Objective: Femoral head fractures are rare injuries that are often associated with poor functional outcome and complications. Fracture management and surgical methods for these fractures are variable. The purpose of this study was to evaluate the incidence, treatment methods and approaches, complications and functional outcomes of femoral head fractures.Methods: We conducted a retrospective review of fifty patients who sustained femoral head fractures from January 2011- December 2018. There were thirty-seven males and thirteen females with median age of 40 years. A surgical approach and fixation method were recorded. Patients were classified according to the Pipkin Classification system. Clinical results were evaluated for patients with two years or greater follow-up using the Modified Harris Hip Score (MHHS). Results: Eight patients (16%) were managed successfully with closed reduction without surgery and thirty-seven (74%) patients required operative reduction and internal fixation (ORIF) of the femoral head and acetabulum, 5 (10%) patients required immediate Total Hip Replacement (THR). Six (12%) developed AVN, four (8%) requiring secondary total hip replacement (THR). Sixteen patients (33%) developed PTA, eight (16%) developed HO and six patients (12 %) had sciatic nerve injury, none requiring operative treatment. Overall functional results, according to modified Harris hip score were excellent in two (4%) patients, good in sixteen (32%) patients, fair in twenty-two (44%) patients, and poor in ten (20%) patients. A statistically significant difference in outcome was observed among four pipkin subtypes. Conclusion: Femoral head fracture are a rare injury that are often associated with poor outcome. In this study we report the functional outcomes and complications of all treatment approaches for femoral head fracture based on Pipkin classification. This study, adds to the growing literature on femoral head fractures and provide reference for the clinical treatment to guide patient management.

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Section: Discussionmentioning

confidence: 92%

Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors

Shakya

Sun

Xiang

2021

Preprint

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“…All cases developed complications and required THR as a definitive procedure [ 6 ]. These reports and others suggest that a Pipkin type-III fracture is a predictor of THR, regardless of patient age [ 6 , 13 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 94%

Terrible triad of the hip: A case report

Alyousif

Aleisawi

Alkaff

et al. 2021

International Journal of Surgery Case Reports

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“…Instead, total hip arthroplasty is more suitable for elderly patients with an associated femoral neck fracture (Pipkin III), allowing them to start walking sooner, with lower complications rate. According to literature, Pipkin III fractures treated with Total hip replacement (THR) have a better outcome than those treated with ORIF, requiring a THR after failure of the internal fixation [ 22 – 24 ]. In elderly patients with fractures of both acetabulum and femoral head (Pipkin IV), fixation and total hip replacement represent a valid and definitive surgical option [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

Mauro

Rovere

Smakaj

et al. 2021

BMC Musculoskelet Disord

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Background The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required. Case presentation Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D’Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9–100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d’Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients. Conclusions Gibson’s approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications.

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Clinical results of femoral head fracture-dislocation treated according to the Pipkin classification

Cited by 24 publications

References 16 publications

Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors

Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors

Terrible triad of the hip: A case report

Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

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