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Orthopedics. 2013 Jun;36(6):778-82. doi: 10.3928/01477447-20130523-24.

Emergent surgical reduction and fixation for Pipkin type I femoral fractures.

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  • 1Department of Orthopaedic Surgery, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People‚Äôs Liberation Army, Zhangzhou, China.

Abstract

The purpose of this study was to assess the effect of timing of large fragment fixation in patients with Pipkin type-I fractures. Patients with Pipkin type-I fractures from the authors' trauma center were prospectively observed between July 2007 and July 2010. Fragments that constituted more than one-fourth of the femoral head were included. Thirty-six patients were equally randomized to undergo emergent surgical reduction and fixation or secondary operative fixation after emergent closed reduction. No significant differences existed between the 2 groups with regard to the baseline characteristics, operating time, and blood loss (P>.05). However, the emergent surgical reduction and fixation group had a shorter hospital stay (P<.05). The results after more than 2-year follow-up showed that the complication and avascular necrosis rates were higher in the secondary operative fixation after emergent closed reduction group compared with the emergent surgical reduction and fixation group (P<.05). It was difficult to achieve an anatomically reduced femoral head when the fragments constituted more than one-fourth of the femoral head. Patients who underwent secondary operative fixation after emergent closed reduction had a high avascular necrosis rate and a relatively poor outcome. Emergent surgical reduction and fixation should be performed shortly after injury to enhance the treatment outcome.

Copyright 2013, SLACK Incorporated.

[PubMed - indexed for MEDLINE]
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