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Abstract
Purpose
This study examined the treatment of patients with posterior hip dislocation and femoral head fracture, according to the Pipkin classification, and we analyzed their clinical and radiological results.
Materials and Methods
The subjects consisted of 45 patients who were treated for posterior hip dislocation and femoral head fracture. The subjects had an average age of 39, and 38 were men and 7 were women. The average follow-up period was 33 months. The cause of injury was traffic accident in 41 cases and falling for the other four cases. According to the classification, there were 26 Type I cases, 5 Type II cases, 1 Type III case and 13 Type IV cases. The treatment methods were selected according to the patients' condition and the form of fracture. The Ebstein criteria and the Merle d'Aubigne and Postel score were used to determine whether there was a combined injury and to examine the clinical and radiological results.
Results
All the cases classified as Type I, II and III showed good or excellent clinical results. A primary osteosynthesis was performed on the Type III cases according to the patient's age and condition, with particularly good results. An anatomical reduction in the early stages affected the clinical results of the Type IV cases. The observed complications were posttraumatic osteoarthritis (38.4%) and avascular necrosis (15.3%).
Figures and Tables
Fig. 1
(A) A 42-year-old male sustained Pipkin type III fracture of hip. (B) Open reduction and internal fixation with Acutrak and sliding hip compression plate. (C) Good clinical & roentgenographic results were obtained in final follow up (Postoperative 24 months).
Fig. 2
(A) A 64-year-old man sustained Pipkin type IV fractures of hip. (B) Open reduction and internal fixation with one 3.5mm screw and spring plate and reconstruction plate. (C) Postoperative radiographs after 7 years follow-up shows an osteophyte on the right femoral head and minimal osteoarthritis change on the joint , but patient was pain free and full range of motion.
Table 1
Case Analysis
*M&P Score: Merle d'Aubigne' & Postel Score, †DCP/A: Siding Hip Screw and Compression Plate with Acutrak
‡THA: Total Hip Arthroplasty, §OR&IF: Open Reduction and Internal Fixation, ∥Hetero: Heterotrophic Ossification
¶PTOA: Post Traumatic Osteo Arthritis, **AVN: Avascular Necrosis, ††NP: Nerve Palsy
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