Yin Xiang-Yu, Liu Yi, Liu Wen-Guang, Yin Qing-Feng
Department of Sports Medicine, the Second Hospital of Shandong University, Jinan, China.
Arthrosc Tech. 2024 Jun 19;13(10):103090. doi: 10.1016/j.eats.2024.103090. eCollection 2024 Oct.
Femoral head fractures are relatively uncommon high-energy injuries and usually associated with traumatic hip dislocation. Pipkin classified these fractures into 4 types according to the location of the head fragment related to the fovea and associated lesions on the femoral neck or acetabulum. Traditional open reduction and internal fixation for femoral head fracture has been proven to be effective, but it could be associated with significant complications. Arthroscopic fixation with screws is a less-invasive alternative to open reduction and internal fixation that offers several advantages. However, technical challenges could be encountered during the procedure and catastrophic consequences could occur in cases of fixation failure. Therefore, we propose an effective arthroscopic technique for Pipkin type I (small fracture caudal to the fovea capitis) femoral head fractures that uses an absorbable suture anchors. The anchors provide initial stability to the fracture fragments, and then the sutures are tied in a double-pulley fashion to further secure the fracture. Finally, a triangular suture bridge ("letter V") is created, which supplies a convenient and stable fixation for proper femoral head fracture.
股骨头骨折是相对少见的高能损伤，通常与创伤性髋关节脱位相关。皮普金根据股骨头骨折块相对于股骨头凹的位置以及股骨颈或髋臼的相关损伤，将这些骨折分为4型。传统的股骨头骨折切开复位内固定术已被证明是有效的，但可能会伴有严重并发症。螺钉关节镜固定术是一种侵入性较小的切开复位内固定替代方法，具有多种优势。然而，手术过程中可能会遇到技术挑战，固定失败时可能会产生灾难性后果。因此，我们提出一种针对皮普金I型（股骨头凹尾侧小骨折）股骨头骨折的有效关节镜技术，该技术使用可吸收缝线锚钉。这些锚钉为骨折块提供初始稳定性，然后以双滑轮方式系紧缝线以进一步固定骨折。最后，形成一个三角形缝线桥（“字母V”），为合适的股骨头骨折提供方便且稳定的固定。
