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Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head

Received: 8 August 2016     Accepted: 16 August 2016     Published: 2 September 2016
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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.

Published in Journal of Surgery (Volume 4, Issue 5)
DOI 10.11648/j.js.20160405.13
Page(s) 100-104
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Pipkin Fracture, Trochanteric Flip Osteotomy, Herbert Screw, Internal Fixation

References
[1] Birkett J. Description of a Dislocation of the Head of the Femur, complicated with its Fracture; with Remarks. Med Chir Trans. 1869. 52: 133-8.
[2] PIPKIN G. Treatment of grade IV fracture-dislocation of the hip. J Bone Joint Surg Am. 1957. 39-A (5): 1027-42 passim.
[3] THOMPSON VP, EPSTEIN HC. Traumatic dislocation of the hip; a survey of two hundred and four cases covering a period of twenty-one years. J Bone Joint Surg Am. 1951. 33-A (3): 746-78; passim.
[4] Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001. 83 (8): 1119-24.
[5] Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973. 55(8): 1629-32.
[6] Giannoudis PV, Kontakis G, Christoforakis Z, Akula M, Tosounidis T, Koutras C. Management, complications and clinical results of femoral head fractures. Injury. 2009. 40(12): 1245-51.
[7] Ross JR, Gardner MJ. Femoral head fractures. Curr Rev Musculoskelet Med. 2012. 5 (3): 199-205.
[8] Oransky M, Martinelli N, Sanzarello I, Papapietro N. Fractures of the femoral head: a long-term follow-up study. Musculoskelet Surg. 2012. 96 (2): 95-9.
[9] Nishino M, Matsumoto T, Nakamura T, Tomita K. Pathological and hemodynamic study in a new model of femoral head necrosis following traumatic dislocation. Arch Orthop Trauma Surg. 1997. 116 (5): 259-62.
[10] Bartonicek J, Rammelt S. History of femoral head fracture and coronal fracture of the femoral condyles. Int Orthop. 2015. 39 (6): 1245-50.
[11] Marecek GS, Scolaro JA, Routt ML Jr. Femoral Head Fractures. JBJS Rev. 2015. 3 (11).
[12] Bauer GJ, Sarkar MR. [Injury classification and surgical approach in hip dislocations and fractures]. Orthopade. 1997. 26 (4): 304-16.
[13] Wang CG, Li YM, Zhang HF, Li H, Li ZJ. Anterior approach versus posterior approach for Pipkin I and II femoral head fractures: A systemic review and meta-analysis. Int J Surg. 2016. 27: 176-81.
[14] Swiontkowski MF, Thorpe M, Seiler JG, Hansen ST. Operative management of displaced femoral head fractures: case-matched comparison of anterior versus posterior approaches for Pipkin I and Pipkin II fractures. J Orthop Trauma. 1992. 6 (4): 437-42.
[15] Gautier E, Ganz K, Krugel N, Gill T, Ganz R. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000. 82 (5): 679-83.
[16] Hu LY, Jia QY, Yu Y, Cao Y, Zheng SQ. [Clinical effects of internal fixation with Herbert screws for the treatment of Pipkin femoral head fractures]. Zhongguo Gu Shang. 2016. 29 (2): 162-6.
[17] Barber FA. Complications of Biodegradable Materials: Anchors and Interference Screws. Sports Med Arthrosc. 2015. 23 (3): 149-55.
[18] Herbert TJ, Fisher WE, Leicester AW. The Herbert bone screw: a ten year perspective. J Hand Surg Br. 1992. 17 (4): 415-9.
Cite This Article
  • APA Style

    Kai Sun, Lin Zhou, Zhizhong Li. (2016). Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head. Journal of Surgery, 4(5), 100-104. https://doi.org/10.11648/j.js.20160405.13

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    ACS Style

    Kai Sun; Lin Zhou; Zhizhong Li. Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head. J. Surg. 2016, 4(5), 100-104. doi: 10.11648/j.js.20160405.13

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    AMA Style

    Kai Sun, Lin Zhou, Zhizhong Li. Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head. J Surg. 2016;4(5):100-104. doi: 10.11648/j.js.20160405.13

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  • @article{10.11648/j.js.20160405.13,
      author = {Kai Sun and Lin Zhou and Zhizhong Li},
      title = {Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head},
      journal = {Journal of Surgery},
      volume = {4},
      number = {5},
      pages = {100-104},
      doi = {10.11648/j.js.20160405.13},
      url = {https://doi.org/10.11648/j.js.20160405.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160405.13},
      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.},
     year = {2016}
    }
    

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    AU  - Kai Sun
    AU  - Lin Zhou
    AU  - Zhizhong Li
    Y1  - 2016/09/02
    PY  - 2016
    N1  - https://doi.org/10.11648/j.js.20160405.13
    DO  - 10.11648/j.js.20160405.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
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    EP  - 104
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20160405.13
    AB  - 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.
    VL  - 4
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    ER  - 

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Author Information
  • The First Clinical Medical College

  • Department of Osteology, the First Affiliated Hospital of Jinan University, Guang Zhou, China

  • Department of Osteology, the First Affiliated Hospital of Jinan University, Guang Zhou, China

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