S Lederer1, M Tauber, S Karpik, R Bogner, A Auffarth, H Resch. 1. Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Paracelsus Medizinische Universität, Salzburger Landeskliniken, Müllner Hauptstrasse 48, A-5020 Salzburg. S.Lederer@salk.at
Abstract
BACKGROUND: Dislocated fractures of the femoral head are highly infrequent injuries. In line with this multicenter study, a follow-up examination of patients with Pipkin fractures was performed in Austrian trauma centers. The aim of this study was to evaluate the types of fractures, the kind of treatment, and the long-term results. PATIENTS AND METHODS: In sum 46 patients were included in our study. A personal and radiological follow-up examination was carried out. The fractures were classified according to Pipkin. RESULTS: Patients with type I fractures had the best functional outcome according to the Harris Hip Score, followed by patients with type II fractures, type IV fractures, and finally type III fractures. The result of the radiological follow-up examination showed that patients who were treated conservatively or with extirpation of the fragment had a lower grade of arthrosis. The poorest radiological outcome was seen in patients who underwent surgical treatment with open reduction and internal fixation. The implantation of a total hip prosthesis was necessary in 24% of the patients. A relevant soft tissue calcification was not recorded. CONCLUSION: The size and location of the fractured fragment has a huge influence on the outcome. An exact anatomical reconstruction of the femoral head, especially of the weight-bearing part, is absolutely necessary.
BACKGROUND: Dislocated fractures of the femoral head are highly infrequent injuries. In line with this multicenter study, a follow-up examination of patients with Pipkin fractures was performed in Austrian trauma centers. The aim of this study was to evaluate the types of fractures, the kind of treatment, and the long-term results. PATIENTS AND METHODS: In sum 46 patients were included in our study. A personal and radiological follow-up examination was carried out. The fractures were classified according to Pipkin. RESULTS:Patients with type I fractures had the best functional outcome according to the Harris Hip Score, followed by patients with type II fractures, type IV fractures, and finally type III fractures. The result of the radiological follow-up examination showed that patients who were treated conservatively or with extirpation of the fragment had a lower grade of arthrosis. The poorest radiological outcome was seen in patients who underwent surgical treatment with open reduction and internal fixation. The implantation of a total hip prosthesis was necessary in 24% of the patients. A relevant soft tissue calcification was not recorded. CONCLUSION: The size and location of the fractured fragment has a huge influence on the outcome. An exact anatomical reconstruction of the femoral head, especially of the weight-bearing part, is absolutely necessary.