Abstract
There is no definite protocol in management of Pipkin fracture in relation to operation approach and internal fixations. The aim is to explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures through the trochanteric flip osteotomy (TFO) approach. From January 2010 to December 2014, 12 cases of type I and II Pipkin fracture (including 8 type I,4 type II) treated through TFO approach and internal fixation with Herbert screws. All the patients were followed up 1-4 years with an average of 2.6 years. The whole osteotomies and acetabular fractures healed within 6 to 12 weeks. All patients achieved healing of femoral head fracture after 12-16 months without femoral head necrosis. Heterotopic ossification (HO) occurred in 1 cases after operation which were left untreated. At the last follow-up, excellent and good rate was 91.7%. Treatment of type I, II Pipkin fracture through TFO approach can provide good visualization and protect of the femoral head blood supply. The treatment of internal fixation with Herbert screws is effective for Pipkin type I and type II femoral head fracture.
Highlights
Introduction which surgical approach to useDr John Birkett first described the fracture of femoral head in 1869 in a 35-year-old woman [1]
The most widely used classification was that of Pipkin which is based on the location of the femoral head fracture in relation to the fovea and additional lesion on the femoral neck or acetabulum
Pipkin Type I is femoral head fracture inferior to the fovea centralis
Summary
Introduction which surgical approach to useDr John Birkett first described the fracture of femoral head in 1869 in a 35-year-old woman [1]. The most widely used classification was that of Pipkin which is based on the location of the femoral head fracture in relation to the fovea and additional lesion on the femoral neck or acetabulum. Pipkin Type I is femoral head fracture inferior to the fovea centralis. Type II fracture extended superior to the fovea centralis. Type III any femoral head fracture with an associated femoral neck fracture. Type IV any femoral head fracture with an associated acetabular fracture [2]. About 55-65% of femoral head fractures have been reported to be Type I and Type II. There is still no consensus on the management of Pipkin type I and type II injuries: whether to treat these fractures operatively or non-operatively, whether to fix or excise the head fragment, or Journal of Surgery 2016; 4(5): 100-104
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