Lateral hip approach used in the treatment of Pipkin fractures

Objective To investigate the clinical results of lateral hip approach used in the treatment of Pipkin fractures. Methods We retrospectively reviewed 13 male patients who had been treated for Pipkin fractures through lateral hip approach between May 1999 and January 2008. They were all male. Their mean age was 34.5 (rang, 19 to 59) years. According to the Pipkin classification, there were 4 cases of type Ⅰ, 5 type Ⅱ, 2 type Ⅲ and 2 type Ⅳ. All the femoral head fractures were fixed by absorbable screws. Lag screws were used for fixation of acetabular and femoral neck fractures. The outcomes were estimated by indexes like radiographic union, traumatic arthritis, avascular necrosis of the femoral head, heterotopic ossification and Thompson-Epstein scores. Results The mean follow-up time was 48.5 (13 to 105) months. All the patients obtained radiographic union of the fracture. One suffered traumatic arthritis, one avascular necrosis of the femoral head and 4 heterotopic os-sification. By the Thompson-Epstein scoring scale, 6 patients had excellent results, 4 good, 2 fair and one poor. The rate of good to excellent was 76.9%. Conclusion Since the lateral hip approach allows sufficient si-multaneous exposure and fixation of the posterior acetabular wall and femoral head fractures, it may be an ideal surgical approach for the treatment of Pipkin fractures with satisfactory results. Key words: Hip dislocation; Femur head; Fracture fixation, internal; Bone nails; Lateral approach