[Treatment of Pipkin I and II hip fractures by anterolateral hip approach].

OBJECTIVE: To investigate the clinical effect of absorbable screw fixation by anterolateral approach (McFarland and Osborne approach) for the treatment of Pipkin type I and type II fractures.

METHODS: From March 2008 to February 2016, 8 cases of femoral head fractures were treated by absorbable screw fixation through anterolateral approach (McFarland and Osborne approach) including 5 males and 3 females with an average age of 36 years old ranging 23 to 58 years old. The course of the disease was 3 to 12 days (means 5 days). The symptoms at admission included hip pain, deformity and dysfunction. The X-ray and CT image showed femoral head fracture and posterior femoral dislocation. There were 2 cases of Pipkin type I and 6 cases of Pipkin type II. All patients received emergency reduction (Allis) of the posterior dislocation of the hip under the combined intravenous anesthesia. Bone traction was performed after successful reduction. The operation through McFarland and Osborne approach, the Thompson-Epstein system used to evaluate the curative effect postoperative.

RESULTS: All the patients had primary healing after operation without other complications occurred. The 8 patients were followed up for 12 to 36 months with an average of 30 months. All of the patients review of X-ray and CT 6 months postoperative showed fractures consolidated, and the healing time was 3 to 6 months with an average of 4 months. According to Thompson-Epstein scoring system, hip function was excellent in 5 cases, good in 2 cases and fair in 1 case.

CONCLUSIONS: The anterolateral approach of hip joint can not only retain the residual blood supply of femoral head, but also fully expose the acetabulum and femoral head. It is a relatively ideal surgical approach for the treatment of Pipkin type I and type II fractures.