Shakya Sujan, Zhang Qing, Wen Yi, Wen Xinag, Cheng Long
West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2025 Aug 18;12:1554603. doi: 10.3389/fsurg.2025.1554603. eCollection 2025.
Pipkin Type III is extremely rare and is associated with worse prognosis and several complications. There is still no consensus on the management of injuries and whether these fractures should be treated surgically with ORIF or arthroplasty. Pipkin type III involves a combination of ipsilateral femoral head and neck fractures. Physioanatomical complexity of this fracture is often challenging, with a poorer prognosis than any other subgroups. The most common complications after management of Pipkin Type III are avascular necrosis of the femoral head and post-traumatic osteoarthritis. The treatment modality with open reduction and internal fixation (ORIF) or total hip arthroplasty (THA) varies according to the severity of the fracture, patient age, time to surgery, and intraoperative findings. Reoperation and surgical intervention pose significant economic burden, functional impairment, and quality of life. This comprehensive review on Pipkin type III demonstrates a throughout exploration of the existing research publications and case studies, focusing on current understanding treatment management strategies, outcome associated and decision-making frameworks with algorithms for decision schemes. By incorporating additional references of our institutional experiences, it aims to expand the current body of knowledge on Pipkin III fractures, offering fresh perspectives and crucial insights for surgeons in decision-making processes.
皮普金Ⅲ型极为罕见，预后较差且伴有多种并发症。对于此类损伤的处理以及这些骨折是否应采用切开复位内固定术（ORIF）或关节置换术进行手术治疗，目前仍未达成共识。皮普金Ⅲ型涉及同侧股骨头和颈骨折的组合。这种骨折的生理解剖复杂性通常具有挑战性，预后比其他任何亚组都要差。皮普金Ⅲ型处理后最常见的并发症是股骨头缺血性坏死和创伤后骨关节炎。切开复位内固定术（ORIF）或全髋关节置换术（THA）的治疗方式会根据骨折的严重程度、患者年龄、手术时间以及术中发现而有所不同。再次手术和外科干预会带来巨大的经济负担、功能损害和生活质量问题。这篇关于皮普金Ⅲ型的综述全面探讨了现有研究出版物和病例研究，重点关注当前对治疗管理策略、相关结果以及带有决策方案算法的决策框架的理解。通过纳入我们机构经验的更多参考文献，旨在扩展当前关于皮普金Ⅲ型骨折的知识体系，为外科医生在决策过程中提供新的视角和关键见解。
