Conservative versus surgical management of Pipkin type I fractures associated with posterior dislocation of the hip: a randomised controlled trial

Chen, Zhiwen; Lin, Bin; Zhai, Wenliang; Guo, Zhouyi; Zhou, Liang; Zheng, Jianzhong; Lian, Kun; Ding, Zheng-qi

doi:10.1007/s00264-010-1087-4

Cited by 45 publications

(23 citation statements)

References 19 publications

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“…Fractures that extend cranial to the fovea centralis are Pipkin 2 lesions; because these fractures involve the weight-bearing portion of the femoral head, the risk of posttraumatic arthritis or AVN is increased. Pipkin 1 lesions can be treated conservatively with closed reduction if adequate postreduction congruence is achieved with less than 1-mm articular step-off (22), although primary excision of small fragments has also yielded favorable results (23). Because Pipkin 2 fracture fragments extend above the fovea centralis, they may alter the weight-bearing force distribution on the femoral head, potentially leading to accelerated cartilage disease.…”

Section: Intracapsular Fracturesmentioning

confidence: 98%

Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know

et al. 2015

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Each year, more than 250,000 hip fractures occur in the United States, resulting in considerable patient mortality and morbidity. The various types of adult proximal femoral fractures require different treatment strategies that depend on a variety of considerations, including the location, morphologic features, injury mechanism, and stability of the fracture, as well as the patient's age and baseline functional status. The authors discuss femoral head, femoral neck, intertrochanteric, and subtrochanteric fractures in terms of injury mechanisms, specific anatomic and biomechanical features, and important diagnostic and management considerations, including the diagnostic utility of imaging modalities. The authors review clinically important classification systems, such as the Pipkin, Garden, Pauwels, and Evans-Jensen classification systems, with emphasis on differentiating subchondral insufficiency fractures from avascular necrosis of the femoral head and typical subtrochanteric fractures from atypical (often bisphosphonate-related) subtrochanteric fractures. In addition, the authors describe the potential complications and management strategies for each fracture type on the basis of the patient's age and physical condition. A clear understanding of these considerations allows the radiologist to better provide appropriate and relevant diagnostic information and management guidance to the orthopedic surgeon.

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Section: Intracapsular Fracturesmentioning

confidence: 98%

Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know

et al. 2015

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“…4 Operative treatment is generally preferred to ensure joint congruity, early mobilization, and to prevent long-term complications. 5 Although Pipkin type I fractures can be fixed or excised, 6 fixation is usually recommended for type II fractures. 7 Anterior surgical dislocation is widely recommended for operative treatment, 8,9 which can be performed either through a SmithPeterson 10 or the Ganz approach.…”

Section: Discussionmentioning

confidence: 99%

Ganz Surgical Dislocation of the Hip Is a Safe Technique for Operative Treatment of Pipkin Fractures. Results of a Prospective Trial

Gavaskar

Tummala²

2015

Journal of Orthopaedic Trauma

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“…Using Thompson and Epstein and Merle d'Aubigne scores, the surgical group's functional outcome was demonstrated to be better than the closed reduction group. The only 2 cases of AVN were found in the conservatively treated group [31] . No consensus regarding care after closed reduction of TDH is in place.…”

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confidence: 94%

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

Connelly

O’Grady²

2015

International Journal of Orthopaedics

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AIM: High velocity athletic injuries account for approximately 5% of adult traumatic hip dislocations (TDHs). The aims of this literature review and case study are to highlight the presentation, pathophysiology and treatment of TDH in athletes and to propose a management algorithm. MATERIALS AND METHODS: A Pubmed search using keywords 'Traumatic hip dislocation,' 'hip injury in athletes' and 'sporting injury' was performed. Each manuscript was individually reviewed. For all cases of TDH secondary to athletic injury, patient presentation, treatment and outcome were recorded. A case of athletics associated TDH from our institution is described. RESULTS: 55 cases of athletics associated TDH were identified in the literature (82% male, 84% posterior). 54.5 % were sustained in snowboarding, 16.4% in skiing, 14.5% in football, 7.3% in rugby and 1.8% in basketball, skating, gymnastics and tennis. A concomitant femoral or acetabular fracture was demonstrated in 16 and 9 patients respectively. Two sustained a sciatic nerve injury. Conservative closed hip reduction was successful in 100% of cases attempted. We present a case of a 31 year old female who sustained a TDH playing Gaelic football treated with closed reduction. CONCLUSION: TDH from sporting injury is a relatively rare, commonly isolated injury that is amenable to closed reduction in the majority of cases. We report the first documented case of traumatic hip dislocation in Gaelic football and propose a management algorithm.

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Conservative versus surgical management of Pipkin type I fractures associated with posterior dislocation of the hip: a randomised controlled trial

Cited by 45 publications

References 19 publications

Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know

Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know

Ganz Surgical Dislocation of the Hip Is a Safe Technique for Operative Treatment of Pipkin Fractures. Results of a Prospective Trial

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

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