Pipkin type IV femoral head fractures: a case series and review of literature

Engel, J. L.; Johnsen, Parker H.; Patel, Nirav K.; Satpathy, Jibanananda; Mounasamy, Varatharaj

doi:10.1007/s00590-020-02838-5

Cited by 15 publications

(23 citation statements)

References 8 publications

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“…Nine studies included a total of 129 FHFs from which basic demographic data were extracted (the data on outcomes were extracted from 127 FHFs, as in one study[ 15 ], the authors reported missing the assessment of two patients in their results section). Two studies[ 15 , 16 ] were prospective, while seven[ 11 - 14 , 17 - 19 ] were retrospective. Across studies, the mean age was 38.2 years (range from 17 to 64).…”

Section: Resultsmentioning

confidence: 99%

“…Blood loss: It was reported in six studies[ 12 - 14 , 16 - 18 ]. However, we were able to pool the results of five studies[ 12 - 14 , 16 , 17 ] due to incomplete data from the sixth study. We used the random effect model for analysis as significant heterogeneity was detected ( I² = 91.52%, P = 0.000).…”

Section: Resultsmentioning

confidence: 99%

“…Posttraumatic OA : OA was reported in five studies[ 11 , 15 , 17 , 19 ]. We used the random effect model for analysis as significant heterogeneity was detected ( I² = 71.82%, P = 6.696).…”

Section: Resultsmentioning

confidence: 99%

“…Nonunion of the TFO was reported in five studies[ 11 , 13 - 16 , 19 ] and occurred at an incidence of 3.4% (3 out of 89 hips). Presence of infection was reported in six studies[ 13 - 17 , 19 ] and occurred at an incidence of 2.1% (2 out of 97 hips). Trochanteric bursitis was reported in one study[ 15 ], which occurred at an incidence of 3.8% (1 out of 26 hips).…”

Section: Resultsmentioning

confidence: 99%

“…Reoperation rate was reported in eight studies[ 11 - 17 , 19 ]. No significant heterogeneity was detected ( I² = 36.16%, P = 0.140) using the fixed effect model for analysis.…”

Section: Resultsmentioning

confidence: 99%

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Safety and efficacy of surgical hip dislocation in managing femoral head fractures: A systematic review and meta-analysis

Khalifa¹,

Haridy²,

Fergany³

2021

WJO

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BACKGROUND Femoral head fractures (FHFs) are considered relatively uncommon injuries; however, open reduction and internal fixation is preferred for most displaced fractures. Several surgical approaches had been utilized with controversial results; surgical hip dislocation (SHD) is among these approaches, with the reputation of being demanding and leading to higher complication rates. AIM To determine the efficacy and safety of SHD in managing FHFs by reviewing the results reported in the literature. METHODS Major databases including PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched to identify studies reporting on outcomes of SHD utilized as an approach in treating FHFs. We extracted basic studies data, surgery-related data, functional outcomes, radiological outcomes, and postoperative complications. We calculated the mean differences for continuous data with 95% confidence intervals for each outcome and the odds ratio with 95% confidence intervals for binary outcomes. P < 0.05 was considered significant. RESULTS Our search retrieved nine studies meeting our inclusion criteria, with a total of 129 FHFs. The results of our analysis revealed that the average operation time was 123.74 min, while the average blood loss was 491.89 mL. After an average follow-up of 38.4 mo, a satisfactory clinical outcome was achieved in 85% of patients, with 74% obtained anatomical fracture reduction. Overall complication rate ranged from 30% to 86%, with avascular necrosis, heterotopic ossification, and osteoarthritis being the most common complications occurring at an incidence of 12%, 25%, and 16%, respectively. Trochanteric flip osteotomy nonunion and trochanteric bursitis as a unique complication of SHD occurred at an incidence of 3.4% and 3.8%, respectively. CONCLUSION The integration of SHD approach for dealing with FHFs offered acceptable functional and radiological outcomes with a wide range of safety in regards to the hip joint vascularity and the development of avascular necrosis, the formation of heterotopic ossification, and the development of posttraumatic osteoarthritis; however, it still carries its unique risk of trochanteric flip osteotomy nonunion and persistent lateral thigh pain.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Posttraumatic OA : OA was reported in five studies[ 11 , 15 , 17 , 19 ]. We used the random effect model for analysis as significant heterogeneity was detected ( I² = 71.82%, P = 6.696).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Reoperation rate was reported in eight studies[ 11 - 17 , 19 ]. No significant heterogeneity was detected ( I² = 36.16%, P = 0.140) using the fixed effect model for analysis.…”

Section: Resultsmentioning

confidence: 99%

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Safety and efficacy of surgical hip dislocation in managing femoral head fractures: A systematic review and meta-analysis

Khalifa¹,

Haridy²,

Fergany³

2021

WJO

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Pipkin fractures: epidemiology and outcome

Enocson

Wolf

2022

Eur J Trauma Emerg Surg

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Purpose To describe the epidemiology of Pipkin fractures including detailed fracture classification and outcome for joint preservation and death. Methods We extracted data on all Pipkin fractures in the Swedish Fracture Register from 2013 to 2020 in patients ≥ 18 years. The cohort was cross-matched with the Swedish Hip Arthroplasty Register to obtain data on primary or secondary treatment with arthroplasty. We analysed data on age, sex, injury mechanism, fracture classification, treatment including secondary operative treatment with arthroplasty and mortality. Primary outcome was joint preservation. Results In total 47 Pipkin fractures with a median age of 48 years were included. 74% of the fractures were in males. The median follow-up time was 3.5 years. The most common primary treatment was internal fixation (45%), followed by primary arthroplasty (28%), and excision of fragment (15%). Three of the 34 patients with primary non arthroplasty treatment received secondary treatment with arthroplasty. Two patients died within 30 days, and no further deaths occurred up to 1 year after injury. Conclusion Three of four fractures occurred in males and more than half of the fractures were due to high energetic injuries. Half of the patients received internal fixation (predominantly younger patients) and 28% were treated with primary arthroplasty (predominantly older patients). The revision rate was low, and after secondary treatment with arthroplasty two thirds of the patients still had a preserved joint.

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