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Surgical treatment for Pipkin type IV femoral head fracture

Yi-Hsun Yu1, Yung-Heng Hsu1, Ying-Chao Chou1

  • 11 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Journal of Orthopaedic Surgery (Hong Kong)
|January 31, 2017
PubMed

Insights

This study evaluated a modified Gibson approach for Pipkin type IV femoral head fractures. The approach yielded satisfactory radiological and functional outcomes, suggesting its potential for treating this complex injury.

Area of Science:

  • Orthopedic surgery
  • Trauma management

Background:

  • Pipkin type IV femoral head fractures are associated with poor prognosis.
  • Various surgical approaches exist, but none are definitively superior.
  • Optimal treatment for this complex fracture remains debated.

Purpose of the Study:

  • To evaluate the efficacy of a modified Gibson approach for Pipkin type IV femoral head fractures.
  • To assess radiological and functional outcomes following this surgical technique.

Main Methods:

  • A consecutive series of nine patients with Pipkin type IV femoral head fractures were reviewed.
  • All patients underwent surgery via a modified Gibson approach between 2012 and 2013.
  • Surgical procedures, radiological outcomes, and functional outcomes were analyzed.

Main Results:

  • Mean follow-up was 17 months. Mean Merle d'Aubigne score was 16.
  • Seven patients achieved anatomical reduction; two had imperfect reductions.
  • No early post-traumatic osteoarthritis was observed; one patient required hip arthroplasty due to osteonecrosis.

Conclusions:

  • The modified Gibson approach provided satisfactory radiological and functional results for Pipkin type IV femoral head fractures.
  • Further prospective studies with larger patient cohorts are needed to establish an optimal surgical approach.
Abstract

Keywords:
acetabular fracturefemoral head fracturemodified Gibson approachtrochanteric osteotomy

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