Pipkin-Frakturen

Abstract

Femoral head fractures a very rare emergency situation and occur in 4-17% of hip joint dislocations. Of femoral head dislocation fractures 3.7% occur in combination with acetabular fractures. Reduction of the dislocation should be immediately performed. Decisive for whether treatment should be conservative or surgical by resection of the fragments, reconstruction of the femoral head or prosthetic joint replacement, is the grading of the fracture type using the Pipkin classification. Surgical treatment appears to give a better outcome in Pipkin type 1 and Pipkin type 2 fractures than conservative treatment. The in-house cohort of patients showed a good long-term outcome after surgical reconstruction. The follow-up treatment is carried out with 6 weeks of floor contact and pharmaceutical ossification prophylaxis. The danger of secondary femoral head necrosis needs to be considered at all times. In patients aged > 65years a primary endoprosthetic joint replacement is indicated.