Herbert screwing directly via the anterior approach for femoral head fractures of Pipkin type Ⅱ in the youth
10.3760/cma.j.issn.1671-7600.2019.12.006
- VernacularTitle: 直接前入路Herbert钉固定治疗青年Pipkin Ⅱ型股骨头骨折
- Author:
Faqi CAO
1
;
Hang XUE
;
Wu ZHOU
;
Tian XIA
;
Mengfei LIU
;
Zengwu SHAO
;
Yanjiu HAN
;
Jing LIU
;
Guohui LIU
Author Information
1. Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Publication Type:Clinical Trail
- Keywords:
Femoral head fractures;
Fracture fixation, internal;
Surgical procedures, minimally invasive;
Surgical approach
- From:
Chinese Journal of Orthopaedic Trauma
2019;21(12):1047-1051
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate Herbert screwing directly via the anterior approach for femoral head fractures of Pipkin type Ⅱ in the youth.
Methods:A retrospective analysis was conducted of the 16 patients who had been treated at Department of Orthopaedics, Union Hospital, Tongji Medical College for femoral head fractures of Pipkin type Ⅱ from August 2016 to June 2018. They were 9 men and 7 women, aged from 18 to 45 years (mean, 25.6 years). Of them, 10 cases who had been complicated with posterior dis-location of the hip received emergency hip reduction(<6 h) before surgical fixation. All the patients underwent Herbert screwing directly via the anterior approach. Their incision length, operation time, intraoperative blood loss, hospitalization time, Harris hip scores, therapeutic efficacy and complications were recorded.
Results:In this series, the incision length averaged 10.4 cm, operation time 45.6 min, intraoperative blood loss 46.5 mL, and hospitalization time 4.0 d. All the 16 patients were followed up for 11 to 15 months (average, 12.7 months). Their Harris hip scores at preoperation, 3, 6 and 9 months postoperation and at the last follow-up were, respectively, 14.3±2.2, 64.8±2.4, 81.1±4.9, 88.1±4.6 and 91.9±3.4 points, showing a significant difference between any 2 time points (P<0.05). The therapeutic efficacy at the last follow-up by the Thompson-Epstein clinical evaluation was assessed as excellent in 9 cases, as good in 6 and as fair in one. No osteonecrosis of the femoral head or heterotopic ossification was observed by follow-up.
Conclusion:For young patients with femoral head fracture of Pipkin type Ⅱ, Herbert screwing directly via the anterior approach provides easy exposure and manipulation, does not aggravate the blood supply to the femoral head, decreases incidence of heterotopic ossification, and leads to shorter operation time and quick functional recovery of the hip.
