改良 Ludloff 内侧入路治疗 Pipkin Ⅰ型股骨头骨折。

Modified Ludloff's medial approach for management of Pipkin's type I femoral head fracture.

机构信息

Pelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-Alainy Hospital, Cairo University, Cairo, Egypt.

AzeemClinics (Private Clinic), Dokki Administration Towers, Front Tower, 401, 4th Floor, 98 El Tharir street, Ad Doqi, 123111, Giza, Arab Republic of Egypt.

出版信息

Int Orthop. 2021 Jun;45(6):1591-1598. doi: 10.1007/s00264-020-04667-x. Epub 2020 Jun 18.

DOI:10.1007/s00264-020-04667-x

PMID:32556587

Abstract

INTRODUCTION

Numerous approaches were described for the management of Pipkin's type I fracture with no consensus on the "standard of care". The strategic thinking of the ideal access is through the medial approach.

MATERIAL AND METHODS

Using Ferguson intermuscular interval, prospective study was done (January 2014-2019) to evaluate radiological and functional outcomes using HHS and Thompson-Epstein criteria. Fracture patterns were subclassified: anterior and posterior-inferior (AI/PI) requiring different reduction positions.

RESULTS

Twenty-one patients (mean FU = 24.3 months (range, 12-48)) were divided into 14 (67.7%) AI and seven PI. Excision was performed in five (23.8%) (AI = 3 (14.3%) and PI = 2) and ORIF in 16 (AI = 11 (52.4%) and PI = 5). At the last follow-up, two (9.5%) were graded as excellent, 11 (52.4%) as good, three (14.3%) as fair, and five as poor.

CONCLUSION

Modified Ludloff's approach provides safe easy direct access to fracture allowing easy excision or direct anatomical reduction, perpendicular compression, and rigid fixation with minimal complications.

摘要

介绍

对于 Pipkin Ⅰ型骨折的治疗，有许多方法，但对于“标准治疗”尚无共识。理想入路的策略性思维是通过内侧入路。

材料与方法

使用 Ferguson 肌间间隙，前瞻性研究（2014 年 1 月至 2019 年）评估使用 HHS 和 Thompson-Epstein 标准的影像学和功能结果。骨折模式分为前下型（AI/PI）和后下型（PI），需要不同的复位位置。

结果

21 例患者（平均随访 24.3 个月（范围，12-48 个月））分为 14 例（67.7%）AI 和 7 例 PI。5 例（23.8%）行切除术（AI=3 例（14.3%），PI=2 例），16 例行切开复位内固定术（AI=11 例（52.4%），PI=5 例）。末次随访时，2 例（9.5%）评为优，11 例（52.4%）为良，3 例（14.3%）为可，5 例为差。