ANALYSIS OF INFLUENCING FACTORS OF HIP FUNCTIONAL RECOVERY AFTER Pipkin FRACTURE SURGERY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HU Hai , YANG Huilin , WANG Genlin , GAN Minfeng , LI Jigang , CAO Zhihai , WANG Qiang.

Department of Orthopedics, the First Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215006, P.R.China.;

Corresponding author：

Keywords：

Pi pkin fracture; Hip function; Influencing factor

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Objective To investigate the influencing factors of the hi p functional recovery after Pi pkin fracture surgery. Methods The cl inical data were retrospectively analysed, from 37 patients with Pi pkin fracture between May 2002 and February 2009. There were 32 males and 5 females, aged 26 to 98 years (median, 43 years). The causes of injury were traffic accident in 31 cases, a fall ing in 4 cases, and fall ing from height in 2 cases. The time from injury to operation was 1-28 days (mean, 8.6 days). According to the Pi pkin classification criteria, there were 23 cases of type II, 8 cases of type III, and 6 cases of type IV. Open reduction and internal fixation (ORIF) were performed in 27 cases, total hip arthroplasty (THA) in 10 cases.
The relationships between gender, age, time from injury to surgery, type of fracture, treatment way and the hip functional
recovery were analysed statistically. Results All patients achieved heal ing of incision by first intention, no infection and
deep venous thrombosis occurred. All patients were followed up 10 to 94 months with an average of 40.5 months. Bone
fusion was observed at 5-11 months (mean, 8.9 months) in patients undergoing ORIF by X-ray examination; no prosthetic
loosening or subsidence occurred in patients undergoing THA. At last follow-up, Oxford Hip Score (OHS) was 16-58 points
(mean, 37.2 points); the results were excellent in 12 cases, good in 13 cases, fair in 2 cases, and poor in 10 cases. The univarible analysis showed that the type of fracture and treatment way significantly affected the hip functional recovery (P lt; 0.05). The multivarible analysis showed that the type of fracture and treatment way had no significant effect on the hip functional recovery (P gt; 0.05). Conclusion Type and treatment way of Pi pkin fracture may affect postoperative hi p function recovery, so appropriate treatment should be selected based on fracture type to ensure the restoration of joint function.

Citation： HU Hai,YANG Huilin,WANG Genlin,GAN Minfeng,LI Jigang,CAO Zhihai,WANG Qiang.. ANALYSIS OF INFLUENCING FACTORS OF HIP FUNCTIONAL RECOVERY AFTER Pipkin FRACTURE SURGERY. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(4): 433-436. doi: Copy

1.	Kloen P, Siebenrock KA, Raaymakers EL, et al. Femoral head fractures revisited. Eur J Trauma, 2002, 28(4): 221-233.
2.	陈志文, 翟文亮, 丁真奇, 等. 一期人工全髋关节置换治疗中老年Pipkin Ⅳ型股骨头骨折. 临床骨科杂志, 2011, 14(4): 389-391.
3.	余霄, 俞光荣, 陈雁西, 等. Pipkin骨折治疗方法探讨. 国际骨科学杂志, 2010, 31(4): 248-250.
4.	贾正平, 郝彦明, 王洪震, 等. Herbert螺钉前后两路固定治疗股骨头骨折7例. 交通医学, 2011, 25(1): 47-48, 51.
5.	Min BW, Kim SJ. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture. Orthopedics, 2011, 34(5): 349.
6.	Pipkin G. Treatment of grade Ⅳ fracture-dislocation of the hip. J Bone Joint Surg (Am), 1957, 39-A(5): 1027-1042.
7.	干旻峰, 杨惠林, 戴思雨, 等. Herbert螺钉治疗Pipkin’s骨折. 实用骨科杂志, 2007, 13(12): 715-717.
8.	李继刚, 杨惠林, 徐耀增, 等. 选择性一期全髋置换术治疗Pipkin骨折7例分析. 中国矫形外科杂志, 2011, 19(2): 153-155.
9.	Dawson J, Fitzpatrick R, Carr A, et al. Questionnaire on the perception of patients about total hip replacement. J Bone Joint Surg (Br), 1996, 78(2): 185-190.
10.	Sahin V, Karaka ES, Aksu S, et al. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. Trauma, 2003, 54(3): 520-529.
11.	Miyanishi K, Yamaoto T, Isisa T, et al. Increased level of apolipoprote in B/apolipoprote in A1 ratio as a potential risk for osteonerosis. Ann Rheum Dis, 1999, 58(8): 514-516.
12.	Boraiah S, Ragsdale M, Achor T, et al. Open reduction internal fixation and primary total hip arthroplasty of selected acetabular fractures. J Orthop Trauma, 2009, 23(4): 243-248.
13.	McMurtry IA, Quaie A. Closed reduction of the traumatically dislocation hip: a new technique. Injury, 2001, 32(2): 162-164.
14.	Marchetti ME, Steinberg GG, Coumas JM. Intermediate-term experience of Pipkin fracture-dislocations of the hip. J Orthop Trauma, 1996, 10(7): 455-461.
15.	Lederer S, Tauber M, Karpik S, et al. Fractures of femoral head. A multicenter study. Unfallehimrg, 2007, 110(6): 513-520.
16.	Stannard JP, Harris HW, Volgas DA, et al. Functional outcome of patients with femoral head fractures associated with hip dislocations. Clin Orthop Relat Res, 2000, (377): 44-56.
17.	Krempaský O, Knybel T. The Pipkin fracture. Acta Chir Orthop Traumatol Cech, 2001, 68(5): 304-310.
18.	张海波, 王义生, 张世清. 人工髋关节置换术在治疗PipkinⅢ型骨折中的临床应用. 中国骨与关节损伤杂志, 2010, 25(4): 317-318.
19.	韩庆辉, 李立钧, 陈国庭, 等. 影响髋骨节后脱位合并股骨头骨折预后的因素分析. 中华医学会第十三届骨科学术会议暨第六届COA国际学术大会, 2011.

1. Kloen P, Siebenrock KA, Raaymakers EL, et al. Femoral head fractures revisited. Eur J Trauma, 2002, 28(4): 221-233.
2. 陈志文, 翟文亮, 丁真奇, 等. 一期人工全髋关节置换治疗中老年Pipkin Ⅳ型股骨头骨折. 临床骨科杂志, 2011, 14(4): 389-391.
3. 余霄, 俞光荣, 陈雁西, 等. Pipkin骨折治疗方法探讨. 国际骨科学杂志, 2010, 31(4): 248-250.
4. 贾正平, 郝彦明, 王洪震, 等. Herbert螺钉前后两路固定治疗股骨头骨折7例. 交通医学, 2011, 25(1): 47-48, 51.
5. Min BW, Kim SJ. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture. Orthopedics, 2011, 34(5): 349.
6. Pipkin G. Treatment of grade Ⅳ fracture-dislocation of the hip. J Bone Joint Surg (Am), 1957, 39-A(5): 1027-1042.
7. 干旻峰, 杨惠林, 戴思雨, 等. Herbert螺钉治疗Pipkin’s骨折. 实用骨科杂志, 2007, 13(12): 715-717.
8. 李继刚, 杨惠林, 徐耀增, 等. 选择性一期全髋置换术治疗Pipkin骨折7例分析. 中国矫形外科杂志, 2011, 19(2): 153-155.
9. Dawson J, Fitzpatrick R, Carr A, et al. Questionnaire on the perception of patients about total hip replacement. J Bone Joint Surg (Br), 1996, 78(2): 185-190.
10. Sahin V, Karaka ES, Aksu S, et al. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. Trauma, 2003, 54(3): 520-529.
11. Miyanishi K, Yamaoto T, Isisa T, et al. Increased level of apolipoprote in B/apolipoprote in A1 ratio as a potential risk for osteonerosis. Ann Rheum Dis, 1999, 58(8): 514-516.
12. Boraiah S, Ragsdale M, Achor T, et al. Open reduction internal fixation and primary total hip arthroplasty of selected acetabular fractures. J Orthop Trauma, 2009, 23(4): 243-248.
13. McMurtry IA, Quaie A. Closed reduction of the traumatically dislocation hip: a new technique. Injury, 2001, 32(2): 162-164.
14. Marchetti ME, Steinberg GG, Coumas JM. Intermediate-term experience of Pipkin fracture-dislocations of the hip. J Orthop Trauma, 1996, 10(7): 455-461.
15. Lederer S, Tauber M, Karpik S, et al. Fractures of femoral head. A multicenter study. Unfallehimrg, 2007, 110(6): 513-520.
16. Stannard JP, Harris HW, Volgas DA, et al. Functional outcome of patients with femoral head fractures associated with hip dislocations. Clin Orthop Relat Res, 2000, (377): 44-56.
17. Krempaský O, Knybel T. The Pipkin fracture. Acta Chir Orthop Traumatol Cech, 2001, 68(5): 304-310.
18. 张海波, 王义生, 张世清. 人工髋关节置换术在治疗PipkinⅢ型骨折中的临床应用. 中国骨与关节损伤杂志, 2010, 25(4): 317-318.
19. 韩庆辉, 李立钧, 陈国庭, 等. 影响髋骨节后脱位合并股骨头骨折预后的因素分析. 中华医学会第十三届骨科学术会议暨第六届COA国际学术大会, 2011.

Chinese Journal of Reparative and Reconstructive Surgery

ANALYSIS OF INFLUENCING FACTORS OF HIP FUNCTIONAL RECOVERY AFTER Pipkin FRACTURE SURGERY

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