Ganz Surgical Dislocation of the Hip Is a Safe Technique for Operative Treatment of Pipkin Fractures. Results of a Prospective Trial

OBJECTIVES: The primary objective was to study the incidence of femoral head osteonecrosis after Ganz approach for Pipkin fracture dislocations. Clinico-radiological and functional outcomes were also studied. DESIGN: Prospective, nonrandomised. SETTING: Tertiary care trauma center. PATIENTS: Twenty-eight patients with type I/II Pipkin fracture dislocation reduced within 6 hours of injury. INTERVENTION: The displaced head fracture was addressed through safe surgical dislocation after urgent closed reduction of the hip. OUTCOME MEASUREMENTS: Incidence of osteonecrosis using radiographs and functional outcome using modified Merle d'Aubigne and Oxford scores were studied. RESULTS: Twenty-six fractures were fixed, and 2 type I fractures were excised. Twenty-six of 28 patients were followed up for a mean of 36 months. There was no osteonecrosis. All fractures and osteotomies had united. The mean modified Merle d'Aubigne score was 16.5 (14-18), and the mean Oxford score was 42.65 (38-48). CONCLUSIONS: Safe surgical dislocation provides satisfactory results in Pipkin fracture dislocations. The incidence of osteonecrosis is not increased in patients undergoing early joint reduction. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.