[Treatment and short-term effect analysis of Pipkin fracture]

Huapeng Guan, Xinwei Liu, Jiacan Su, Chuncai Zhang, Jianzhong Sun, Qingge Fu
Chinese Journal of Reparative and Reconstructive Surgery 2009, 23 (3): 265-7

OBJECTIVE: To summarize the treatment method and to analyze short-term therapeutic effect of Pipkin fracture.

METHODS: From January 2002 to January 2007, 14 cases of Pipkin fracture were treated. There were 10 males and 4 females with an average of 33.5 years (ranged from 28 to 52 years). Fractures were caused by traffic accident. According to Pipkin's classification, there were 4 cases of type I, 6 cases of type II, 2 cases of type III and 2 cases of type IV. The time from injury to operation was 24 hours to 8 weeks. All patients received open reduction under Kocher-Langenbeck approach, ameliorative posterior-lateral approach or combined approaches. Absorbable screws and suture line internal fixation were performed in fracture of the femoral head, titanium cannulated screws were used to fix the femoral intertrochanteric fracture in type III, and acetabular tridimensional memory fixation systems were used to fix the posterior acetabular fracture in type IV.

RESULTS: All cases had one-stage wound healing, no complications of deep infection and thrombosis of deep vein of lower limb occurred. All the patients were followed up for 12-48 months (mean 26 months). One case of type III fracture for Pipkin had necrosis of femoral head after 1 year of reduction and fixation, and received total hip replacement; other patients achieved bony healing after 6-10 months (mean 8 months). According to D'Aubigne-Postel score, the results were excellent in 5 cases, good in 6 cases, fair in 2 cases and poor in 1 case; the excellent and good rate was 78.6%.

CONCLUSION: It is important for the patients with Pipkin fracture to early diagnose, to select proper operation approach, to stably fix fracture and to manage after operation in reducing complication and recovering hip joint function.

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