USING THE PIPKIN CLASSIFICATION IN DETERMINING THE TREATMENT TACTICS OF FEMORAL HEAD FRACTURES

Abstract

Femoral head fractures are a rare injury with limited information in the literature. Recent studies have been based on small case series, indicating that the incidence of fractures in hip dislocation varies from 7 to 18 %. Fractures of the femoral head are classified according to Pipkin. Treatment is often accompanied by significant complications, and the choice of the optimal treatment method remains a matter of debate. The choice of treatment tactics affects the duration of treatment and functional outcome. The article presents the results of treatment of patients whose treatment tactics were based on the Pipkin classification. Objective. To substantiate the use of the Pipkin classification of femoral head fractures in the selection of treatment and diagnostic tactics. Methods. The study was performed by evaluating the results of treatment in 44 patients. The Pipkin classification was used to determine the treatment tactics. The results were evaluated according to the HHS scale. The results were statistically analysed by comparing the median scores for different groups using the Mann-Whitney U test. Results. The worst prognosis was for patients with Pipkin III and Pipkin IV fractures. HHS scores for patients with complicated outcomes are worse than for patients with uncomplicated outcomes. Treatment outcomes for Pipkin type III fractures are statistically significantly lower than for other types. Conclusions. Pipkin fractures are a rare and severe injury that can cause significant limb dysfunction with proper treatment. Treatment of Pipkin type I and type II includes immediate reduction of the dislocation and conservative treatment in case of satisfactory fragmentation or open reduction with metal osteosynthesis for displaced fractures; for type III and IV, open reduction and osteosynthesis are possible for young patients, and primary arthroplasty is recommended for patients over 60 years of age or with concomitant metabolic diseases.