Pipkin骨折的治疗及并发症分析

Treatment and complications of posterior dislocation of hip joint combined with fracture of the femur head

目的:探讨11例髋关节后脱位合并股骨头骨折(Pipkin骨折)治疗方法及并发症。方法:治疗随访1997～2008年收治11例髋关节后脱位合并股骨头骨折(Pipkin骨折)病人。据Pipkin分型,Ⅰ型5例,Ⅱ型5例,Ⅲ型1例。据分型、年龄、术前影像及术中探查综合考虑治疗方法。闭合复位2例,取出游离小骨块3例,普通拉力螺钉固定1例,可吸收螺钉固定骨折块5例。结果:随访11个月～9年,疗效优4例,良4例,可2例,1例失访,优良率72.7%。结论:治疗效果的关键是早期诊断,适当扩大手术指征,据个体化原则选用手术切口及固定。可吸收螺钉固定是较好选择。

Objective ： To investigate the treatment of posterior dislocation of hip joint combined with fractures of the femoral head （Pipkin＇s fracture） and prevention of the complications. Methods： Between i997 and 2008,11 patients received the treatment of Pipkin＇s fracture. By Pipkin＇s classification,5 cases were in type Ⅰ and another 5, type Ⅱ. Only 1 case was in type Ⅲ. The treatment program was based on the classification, ages, preoperative image analysis and inu3operative findings. Two cases underwent closed reduction, 3 were treated by removal of the small free bones, 1 case was given common lag screw fixation and 5 were undergone by open reduction and fixation with absorbable screw. Results： The follow-up during 11 months to 9 years showed that 3 cases were cured,4 were in good and 2, in fair condition. One case failed to be followed. 72.7% recovered satisfactorily. Conclusion： Early diagnosis and free surgical indications are important to treatment of Pipkin＇s fracture. In addition,operative incision and fixation must be based on the individual condition. Absorbable screw may be preferable in the fixation of the fracture.