scholarly journals Application of Trochanteric Flip Osteotomy with Herbert Screw to Treat Pipkin I,II Fracture of the Femoral Head

2016 ◽  
Vol 4 (5) ◽  
pp. 100
Author(s):  
Kai Sun
Keyword(s):  
Femoral Head ◽  
Herbert Screw ◽  
Trochanteric Flip Osteotomy

scholarly journals Use of Trochanteric Flip Osteotomy Improves the Outcome of Pipkin I and II Femoral Head Fractures

2018 ◽  
Vol 11 (02) ◽  
pp. 26-33
Author(s):  
RM Dhakal ◽  
RP Shrestha ◽  
B Shrestha ◽  
IS Kandel ◽  
KB Bista ◽  
...  
Keyword(s):  
Femoral Head ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Posterior Dislocation ◽  
Road Traffic Accidents ◽  
Femoral Head Fracture ◽  
Anatomical Reduction ◽  
Necrosis Of Femoral Head ◽  
Trochanteric Flip Osteotomy ◽  
Type Of Fracture

Introduction: Annual incidence of femoral head fracture is constantly increasing due to increase in cases of road traffic accidents (RTA). Four to 17% of femoral head fractures are due to posterior dislocations of hip. Outcome of femoral head facture associated with posterior dislocation of hip, the pipkin I and II fracture, is unsatisfactory due to lack of universally accepted protocol for its management and treatment. Objective: To evaluate the patient outcome using relatively newer approach, the Trochanteric Flip (digastrics) Osteotomy (TFO), for the precise anatomical reduction of femoral head fractures associated with posterior dislocation of hip. Methods: Between 2013 and 2017, 21 patients with sustained isolated femoral head fracture were admitted at our hospital. We used TFO approach for the management and treatment of femoral head fractures. The patients were followed up for 42 months at different intervals. Clinical outcome were evaluated using Merle d’Aubigne Postel and Thompson-Epstein scale. Results: Retrospective analysis showed excellent, good, fair and poor results in five (23.8%) patients, 13 (61.9%) patients, two (9.5%) patients and one (4.7%) patient, respectively. Clinical outcomes included sciatic nerve injury (4.7%), moderate arthritis (95.3%), benign non-debilitating heterotrophic ossification (19%), avascular necrosis of femoral head (4.7%) and neuropraxia (4.7%). Conclusions: Use of trochanteric flip osteotomy gives the favorable outcome for the treatment of this type of fracture. Most importantly, the vascularity of femoral head remains intact which makes TFO a very useful technique for pipkin I and II fracture treatment.

Hip Resurfacing using the Trochanteric Flip Osteotomy

2009 ◽  
Vol 19 (2) ◽  
pp. 131-135 ◽  
Author(s):  
Vijay V. Killampalli ◽  
Andrew Hayes ◽  
Nick Parsons ◽  
Mathew L. Costa ◽  
Udai Prakash
Keyword(s):  
Femoral Head ◽  
Clinical Results ◽  
Hip Resurfacing ◽  
Component Failure ◽  
Ucla Activity Score ◽  
Resurfacing Arthroplasty ◽  
Early Results ◽  
Oxford Hip Score ◽  
Trochanteric Flip Osteotomy

We report the early results and complications of resurfacing arthroplasty using the ‘Trochanteric Flip Osteotomy’ approach to the hip. There are no published clinical results of this approach used for resurfacing arthroplasty. One hundred consecutive patients were assessed prospectively for a minimum follow-up of 2 years (range 2 - 5 years). The Oxford Hip Score fell from a median of 30 pre-operatively to 5 at two years. Similar improvement was found in the UCLA Activity Score. There were no cases of component failure or fractures. However, nine patients had minor complications related to the osteotomy. Resurfacing Arthroplasty of the hip may be successfully performed through a trochanteric flip osteotomy. This surgical approach may avoid some of the complications associated with avascular necrosis of the femoral head.

Midterm results of trochanteric flip osteotomy technique for management of fractures around the hip

2017 ◽  
Vol 28 (2) ◽  
pp. 148-155 ◽  
Author(s):  
Vivek Trikha ◽  
Saubhik Das ◽  
Arkesh Madegowda ◽  
Prabhat Agrawal
Keyword(s):  
Femoral Head ◽  
Excellent Result ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Acetabular Fractures ◽  
Functional Evaluation ◽  
Midterm Results ◽  
Surgical Hip Dislocation ◽  
Surgical Dislocation ◽  
Trochanteric Flip Osteotomy

Introduction: In this study, we aimed to investigate safety and efficacy of the trochanteric flip osteotomy with surgical hip dislocation technique in selected displaced acetabular and femoral head fractures with clinico-radiological outcome and potential complications. Materials and methods: We retrospectively reviewed 32 patients from January 2009 to June 2014. Selected displaced acetabular fractures with comminution and/or cranial extension of posterior wall, marginal impaction, intraarticular fragment, femoral head fractures and hip fracture-dislocations were operated by this modified approach of trochanteric flip osteotomy and surgical hip dislocation. Patients were evaluated for fracture reduction, femoral head viability, trochanteric union, abduction power, and functional evaluation was done by Merle d’Aubigné-Postel scoring system. Minimum follow-up was 24 months. Results: Reduction was judged to be anatomical in 84.38% of cases, and within 1-3 millimetres in 9.38% of cases. All osteotomies healed in an anatomical position. Heterotopic ossification was found in 2 patients limited to Brooker class I. Osteonecrosis developed in 1 patient. 2 patients developed arthritis of the hip as sequelae of poor reduction. Abduction power was MRC 5/5 in all except in 1 patient (4/5). Mean Merle d’Aubigné-Postel score was 16.18; overall good to excellent result was achieved in 87.5% of cases. Conclusions: Trochanteric flip osteotomy with surgical dislocation allows better intraarticular assessment, control of intraarticular fragments, assists accurate reduction and the fixation of complex acetabular and femoral head fractures, without compromising femoral head vascularity and abductor strength. This technique has provided excellent midterm results in the management of complex injuries around the hip.

scholarly journals Management of a Pipkin Type III Femoral Head Fracture Via Ganz Approach with a Cannulated Lag Screw & Herbert Screw

2021 ◽  
Author(s):  
Liangcong Hu ◽  
Xudong Xie ◽  
Bobin Mi ◽  
Le Grange Jehane Michael. ◽  
Tiantian Wang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Complication Rate ◽  
Femoral Head Fracture ◽  
Postoperative Function ◽  
Herbert Screw ◽  
Type Iii ◽  
Lag Screw ◽  
Harris Score ◽  
Post Traumatic

Abstract Objective: To evaluate the medium - to long-term efficacy of a Ganz approach and cannulated lag screw combined with Herbert screw, in the management of a Pipkin type III femoral head fracture.Methods:Retrospective analysis was performed on 11 patients (6 males, 5 females) who sustained Pipkin type III femoral head fractures and were managed with a cannulated lag screw, combined with Herbert screw, inserted using the Ganz approach and who were admitted to our department between June 2018 to June 2020. Perioperative indicators, postoperative function and follow-up complications at 9 months after surgery, Harris score at 6 and 9 months after surgery, Thompson-Epstein score, hip femoral head necrosis and incidence of post traumatic hip arthritis were analysis.Results:10 patients completed follow-up, with an average follow-up time of (13.7 ± 2.1) months. The mean operative time was (100.3 ± 23.67) minutes, intraoperative blood loss was (138.6 ± 50.18) ml, peripheral blood hemoglobin (Hb) was (105.6 ± 18.94) g/L 24 hours after surgery, and the complication rate was 1/10 2 weeks after surgery. The Harris Hip Scores for joint function at 6 and 9 months after the operation were (68.6 ± 5.49) points and (88.8 ± 5.77) points respectively. The excellent and good rate in the last follow-up was 80% (Thompson-Epstein score). The complication rate was 10%.Conclusion:A cannulated lag screw combined with a Herbert screw and inserted via the Ganz approach, is an effective method for the treatment of Pipkin type III fractures.

Fixation of femoral head fractures using the Herbert screw

Injury ◽  
1988 ◽  
Vol 19 (3) ◽  
pp. 220-221 ◽  
Author(s):  
P. Murray ◽  
H.M.J. McGee ◽  
N. Mulvihill
Keyword(s):  
Femoral Head ◽  
Herbert Screw

scholarly journals Open reduction and Herbert screw fixation of Pipkin type IV femoral head fracture in an adolescent: A case report

2021 ◽  
Vol 9 (4) ◽  
pp. 898-903
Author(s):  
Yao Liu ◽  
Jin Dai ◽  
Xiao-Dong Wang ◽  
Zhi-Xiong Guo ◽  
Lun-Qing Zhu ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Open Reduction ◽  
Screw Fixation ◽  
Femoral Head Fracture ◽  
Herbert Screw ◽  
Type Iv

The Efficacy of Trochanteric Flip Osteotomy in Cases of Femoral Head Fracture

2013 ◽  
Vol 48 (3) ◽  
pp. 205
Author(s):  
Kyung-Jae Lee ◽  
Byung-Woo Min ◽  
Hyub Sakong ◽  
Young-Jae Lim ◽  
Kyung-Keun Min ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Head Fracture ◽  
Trochanteric Flip Osteotomy

scholarly journals Modified Hardinge approach is an alternative to trochanteric flip osteotomy for Pipkin type IV femoral head fracture

2019 ◽  
Author(s):  
I-Jung Chen ◽  
Ying-Chao Chou ◽  
Yung-Heng Hsu ◽  
Yi-Hsun Yu
Keyword(s):  
Femoral Head ◽  
Blood Loss ◽  
Rank Test ◽  
Type Iv ◽  
Log Rank Test ◽  
Group A ◽  
Group B ◽  
Trochanteric Flip Osteotomy ◽  
Hardinge Approach

Abstract Background Pipkin type IV femoral head (FH) fractures generally have poor prognoses. Although several surgical approaches are used, the optimal procedure is still under debate. The purposes of this study were to compare two approaches, the modified Hardinge approach and trochanteric flip osteotomy, for the treatment of Pipkin type IV FH fractures. Methods This retrospective study included 20 patients who underwent surgical treatment for Pipkin type IV FH fractures between January 2011 and September 2017 at a level 1 trauma center. Thirteen were treated using the modified Hardinge approach (group A) and seven with trochanteric flip osteotomy (group B). All patients completed at least 1 year of follow-up. The clinical outcome of the Merle d’Aubigné-Postel score; and radiological outcomes including the quality of the fracture reduction, the osteonecrosis of the FH (ONFH), the hip joint osteoarthritis (OA), and heterotopic ossification (HO); were compared between the two groups. Conversion to THR was also recorded as an outcome measure, analyzed by Kaplan–Meier curve and log-rank test. Results The mean operative time was similar in the two groups. The estimated blood loss of group B (435.7 ± 307.8 ml) was nearly double that of group A (233.1 ± 116.8 ml), although not statistically significant (P = 0.135). Radiographic outcomes including the quality of fracture reduction, ONFH, hip joint OA, and HO did not differ significantly between the two groups. There were also no significant differences between the two groups in terms of mean Merle d’Aubigné-Postel score at 1 year after injury and the log rank test of conversion to THR. One patient in group A had recurrent dislocation and underwent revision surgery, while one patient in group B requested removal of the trochanteric screws due to discomfort. Conclusions For the management of Pipkin type IV FH fractures, the modified Hardinge approach results in reduced blood loss, similar clinical and radiological outcomes compared with trochanteric osteotomy. The modified Hardinge approach appears to be an acceptable alternative to trochanteric flip osteotomy.

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