Ganz Surgical Dislocation of the Hip Is a Safe Technique for Operative Treatment of Pipkin Fractures. Results of a Prospective Trial.

Abstract

The primary objective was to study the incidence of femoral head osteonecrosis after Ganz approach for Pipkin fracture dislocations. Clinico-radiological and functional outcomes were also studied. Prospective, nonrandomised. Tertiary care trauma center. Twenty-eight patients with type I/II Pipkin fracture dislocation reduced within 6 hours of injury. The displaced head fracture was addressed through safe surgical dislocation after urgent closed reduction of the hip. Incidence of osteonecrosis using radiographs and functional outcome using modified Merle d'Aubigne and Oxford scores were studied. Twenty-six fractures were fixed, and 2 type I fractures were excised. Twenty-six of 28 patients were followed up for a mean of 36 months. There was no osteonecrosis. All fractures and osteotomies had united. The mean modified Merle d'Aubigne score was 16.5 (14-18), and the mean Oxford score was 42.65 (38-48). Safe surgical dislocation provides satisfactory results in Pipkin fracture dislocations. The incidence of osteonecrosis is not increased in patients undergoing early joint reduction. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.