[Operative treatment of femoral head fractures through an anterior minimally invasive incision].
Fractures of the femoral head rarely occur and are often combined with dislocation of the hip joint. A separate classification of the femoral head fracture was described in 1957 by Pipkin. The operative treatment depends on the type of injury and requires extensive knowledge of the various operative approaches. We report on a 40-year-old female patient with Pipkin II fracture and operative treatment of the injury through an anterior minimally invasive incision. We present a review of the literature, evaluate the type of fractures, the kind of approaches and treatment and the long-term results. The dislocation of the hip should be treated by prompt closed reduction followed by traction and immobilization. Open reduction and internal fixation of Pipkin fractures depends on the presence of an obstructive fragment, an inability to obtain and maintain reduction of either the dislocation of the fracture or both and comminution of the fracture bone. When closed methods have failed operation is indicated. The operative treatment may include the excision of small fragments, the internal fixation with bioabsorbable screws, Herbert screws and the internal fixation of femoral neck fractures and acetabular fractures. In some cases salvage procedures like endoprotheses are necessary.
Klinik für Unfallchirurgie und Gelenkchirurgie, Berufsgenossenschaftliche Kliniken Bergmannstrost Halle, Halle/Saale. th_handschuh@gmx.de
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Handschuh
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Grossstück
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Hofmann
D020341:Absorbable Implants; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D016059:Range of Motion, Articular / Q000502:physiology; D014057:Tomography, X-Ray Computed