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

Gavaskar, Ashok S.; Tummala, Naveen C.

doi:10.1097/bot.0000000000000399

Cited by 27 publications

(41 citation statements)

References 16 publications

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“…In a series of 213 hips surgically dislocated with this technique, they did not encounter AVN (follow-ups ranging from two to seven years postoperatively). A prospective trial describing 28 patients undergoing surgery for a Pipkin fracture through Ganz surgical dislocation did not show any AVN at 36 months of follow-up [25]. A 37% rate of heterotopic ossification at one year has been reported with this technique, as seen in our case at 2 years postoperatively (Figure 5(b)).…”

Section: Discussionsupporting

confidence: 59%

Eight-Year Follow-Up Using a Fresh Osteochondral Allograft for a Femoral Head Chondroblastoma in a 17-Year-Old Patient

Moreau

Beauchamp-Chalifour

Belzile

et al. 2019

Case Reports in Orthopedics

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Chondroblastoma is a rare benign tumor that affects the epiphysis of long bones in adolescents. Chondroblastoma located in the femoral head is associated with a higher recurrence rate and carries the additional risks of head collapse and degenerative hip disease. Aggressive curettage followed by bone grafting is the current mainstay of treatment. To our knowledge, the long-term postoperative outcome of this technique remains unknown due to the short follow-up of previous case reports. We present the case of a 17-year-old male who underwent fresh osteochondral allograft following curettage of a femoral head chondroblastoma, using a Ganz surgical hip dislocation. He made an uneventful recovery without tumor recurrence. The patient was followed up to 8 years postoperatively. However, there were clinical and radiographic degenerative changes at 6 years of follow-up.

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Section: Discussionsupporting

confidence: 59%

Eight-Year Follow-Up Using a Fresh Osteochondral Allograft for a Femoral Head Chondroblastoma in a 17-Year-Old Patient

Moreau

Beauchamp-Chalifour

Belzile

et al. 2019

Case Reports in Orthopedics

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“…To our knowledge, there are few prospective studies on the use of Ganz surgical dislocation for femoral head fractures [51, 52]. And this prospective study of 3D printing-based Ganz approach for treatment of femoral head fractures was implemented for the first time.…”

Section: Discussionmentioning

confidence: 99%

3D printing-based Ganz approach for treatment of femoral head fractures: a prospective analysis

et al. 2019

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BackgroundFemoral head fractures are uncommon injuries. Open reduction and internal fixation (ORIF) of femoral head fracture is the preferred treatment for most patients. There are several surgical approaches and treatments for this difficult fracture. However, the optimal surgical approach for the treatment of femoral head fracture remains controversial. Meanwhile, the operation is difficult and the complications are numerous. We prospectively reviewed patients with femoral head fractures managed surgically through the 3D printing-based Ganz approach to define a better approach with the least morbidity.Patients and methodsBetween 2012 and 2017, a total of 17 patients were included in this study. An exact 1:1 3D printing model of the injured hip side was fabricated for each patient and simulated surgery was finished preoperative. The surgical approach was performed as described by Ganz. Functional assessment was performed using the modified Merle d’Aubigne scores. The reduction of the fracture was evaluated according to Matta’s criteria. The incidence of complications, such as heterotopic ossification (HO) and avascular necrosis (AVN), and the need for additional surgery were also documented.ResultsTwelve of 17 patients (four females and eight males) were available for 2 years follow-up. The mean follow-up was 35 months (25–48 months). Average age for the 12 patients was 39.9 ± 12.2 years. According to the Pipkin classification, four patients were type I fracture, three patients were type II fracture, and five patients were type IV fracture. The mean operative time was 124.2 ± 22.1 min, and the estimated blood loss was 437.5 ± 113.1 ml. According to Merle d’ Aubigne scores, excellent results were achieved in six of the 12 patients; four good and two poor results occurred in the rest of the patients. On the radiograph evaluation, fracture reduction was defined as anatomical in eight patients, and imperfect in four. Most patients had good outcomes and satisfactory hip function at last follow-up. Almost all great trochanteric osteectomy healed uneventfully. One patient developed symptomatic AVN of the femoral head and underwent THA at 3 years. After THA, she regained a good hip function with the ability to return to work and almost no reduction in sports activities. Heterotopic ossification was found in four cases (type I-1, type II-2, and type III-1).ConclusionsThe 3D printing-based Ganz approach provides a safe and reliable approach and satisfactory results of treatment in femoral head fractures. Using 3D printed model for the fracture of the femoral head, the fracture can be viewed in every direction to provide an accurate description of fracture characteristics, which contributes to make a reasonable surgical plan for patients. In addition, the 3D printing-based Ganz approach can obtain excellent surgical exposure and protection of the femoral head blood supply, reduce the operation time and intraoperative blood loss, make the precise osteotomy, anatomically fix the intra-articular fragments, and effectively redu...

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“…Choice of approach is controversial 9,10. The approaches often used are anterior approach Smith-Peterson and posterior approach Kocher-Langenbeck.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of femoral head fracture-dislocation treated according to the Pipkin classification

Yu¹,

Pang²,

Chen³

2017

Pak J Med Sci

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Objective:To summarize the clinical results of femoral head fracture-dislocation treated according to Pipkin classification.Methods:Atotal of 19 patients with femoral head fracture-dislocation were retrospectively analyzed from Mar. 2008 to Mar. 2015. According to the classification of Pipkin criteria, there were 4 cases in Type-I, 6 cases in Type-II, 6 cases in Type-IIIand 3 cases in Type-IV. Various procedures were taken according to the different types of the fracture, the time of the fracture, and the age of the patients. X-ray was examined during the follow-up period and functional evaluation was carried out by Harris Hip Score’s criteria. The clinical therapeutic effects were analyzed.Results:All the patientsgot a mean follow-up of 18 months (9-36 months). No patient suffered from infection, skin flap necrosis and X-ray showed no implants loosening or breakage. According to the Harris Hip Score’s criteria, in Type-I, 4 cases were rated as excellent. In Type-II, 2 cases rated as excellent, 3 cases as good and 1 case as fair. In Type-III, 3 cases rated as good, 2 cases as fair and 1 case as poor. In Type-IV, 1 case rated as excellent, 1 case as good and 1 case as fair. The overall rate of excellent and good was 73.7%.Conclusions:Pipkin classification is helpful to make preoperative plan and judging the prognosis in cases of femoral head fracture-dislocation. However, multiple factors such as the time from injury to surgery, the ages of patients, the selection of implants should also be considered, which may affect the clinical results.

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

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 27 publications

References 16 publications

Eight-Year Follow-Up Using a Fresh Osteochondral Allograft for a Femoral Head Chondroblastoma in a 17-Year-Old Patient

Eight-Year Follow-Up Using a Fresh Osteochondral Allograft for a Femoral Head Chondroblastoma in a 17-Year-Old Patient

3D printing-based Ganz approach for treatment of femoral head fractures: a prospective analysis

Clinical results of femoral head fracture-dislocation treated according to the Pipkin classification

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