title: Surgical treatment for Pipkin type IV femoral head fracture.
abstract: Pipkin type IV femoral head (FH) fracture was thought as poor prognosis. There were several surgical approaches and treatments for this difficult fracture. However, there was no one treatment superior to another. We reviewed a serious of patients with Pipkin type IV FH fracture underwent surgery via a modified Gibson approach.
  
  
  
  We reviewed a consecutive series of nine patients with Pipkin type IV FH fracture under surgery via a modified Gibson approach between 2012 and 2013. The surgical procedure was completely described, and the radiological outcome and the functional outcome were also reviewed.
  
  
  
  The mean follow-up duration was 17 (12-30) months. The mean Merle d'Aubigne score was 16 (8-19). Seven patients had anatomical reductions, and two had imperfect reductions by Matta's grading. There was no early posttraumatic osteoarthritis during the follow-up period. One patient with early post-traumatic osteonecrosis 3 months after index surgery underwent total hip arthroplasty.
  
  
  
  Through this surgery approach to fix the FH and the acetabulum, the radiological and the functional results were satisfactory. We still need more patients with prospective study to find an optimal surgical approach for Pipkin type IV FH fracture.
authors.affiliation: 1 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yi-Hsun
authors.initials: YH
authors.lastname: Yu
authors.affiliation: 1 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yung-Heng
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: 1 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Chou
authors.affiliation: 1 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: I-Chuan
authors.initials: IC
authors.lastname: Tseng
authors.affiliation: 2 Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Su
authors.affiliation: 1 Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chi-Chung
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome
keywords: acetabular fracture; femoral head fracture; modified Gibson approach; trochanteric osteotomy