Pipkin骨折治疗的回顾性研究

Treatment of the Pipkin fractures

目的探讨髋关节后脱位伴股骨头骨折（Pipkin骨折）的治疗方法及疗效。方法回顾性分析2003年1月．2009年11月北京市顺义区医院收治的19例髋关节后脱位伴股骨头骨折的患者，其中Ⅰ型8例，Ⅱ型6例，Ⅲ型1例，Ⅳ型4例。其中17例根据病情分别应用切开复位内固定术治疗。结果Ⅰ型8例，2例保守效果为良，手术优3例，良3例。Ⅱ型6例手术优3例，良2例，可1例，Ⅲ型手术1例可，Ⅳ型4例手术中优1例，良2例，可1例。手术优良率达82．4％。结论对于Pipkin骨折患者来说，尽快手术治疗是首选，但手术时机的选择及术式需根据患者的具体病情灵活应用，术中保留骨块及髋关节的完整对于预防创伤性关节炎意义重大，且手术技巧对于保护血运不容忽视。

Objective To investigate the treatment of Pipkin fractures and curative effect. Methods From January 2003 to November 2039, we treated 19 cases of posterior dislocation of the hip with fracture of the femoral head,with type Ⅰ 8 cases, type Ⅱ 6 cases, type Ⅲ 1 case, type Ⅳ4 cases. Seventeen patients were treated according to the illness with internal fixation treatment. Results Among type 1 8 cases, 2 cases were good with conservative treatment, 3 were excellent and 3 were good with surgical treatment ; Among type 116 cases, 3 were excellent, 2 were good, 1 was fair; 1 patient of type Ⅲ was fair; In 4 cases of type Ⅳ, 1 case was excellent, 2 cases were good, 1 case was fair. Conclusions Surgical treatment as soon as quickly is preferred for posterior dislocation of the hip with fracture of the femoral head （ Pipkin fractures）, but the surgical time and methods should be chosen according to patients＇ detailed illness. It is important reserving the hip bone for preventing traumatic arthritis, and surgical skills to protect blood supply should not be ignored.