Background
Fractures of the femoral head (Pipkin fractures) are relatively uncommon. In cases of immediate, gentle reposition, and considerate soft tissue handling during operative treatment, Pipkin 1 and 2 fractures can heal with good long-term results. However, some long-term problems regularly occur. Conservative therapy is possible in cases of anatomic articulation or in the presence of only very small fragments that do not compromise articulation after closed reduction.
Objective
The aim of this study was to evaluate the results of open reduction and internal fixation of femoral head fractures.
Design
All patients were treated with open reduction and screw fixation of the fracture with counter sinking of the screw head.
Patients and methods
Sixteen patients were treated using the anterior Smith-Petersen approach for fixation of femoral head fractures after attempting closed reduction; the average age was 43 years (32–52 years). Postoperative follow-up was for 2 years.
Results
Six patients (37.5%) showed excellent results, four patients (25%) showed good, and six patients (37.5%) showed fair/poor results.
Conclusion
A wide controversy exists in the treatment of femoral head fractures; however, advances in treatment options and rehabilitation protocols make the outcome better by decreasing the incidence of late complications including avascular necrosis, post-traumatic arthritis, and heterotopic ossification.