Pipkin-frattura testa femore-accesso anteriore

Pipkin fractures are fractures of the femoral head. The surgical treatment requires a correct exposition of the fragments. The surgical hip luxation of R.Ganz gives the possibility to treat al femoral head fractures.

Some fracture types can be treated however with other approaches, as a short anterior approach. To adoperate a short anterior approach it is necessary that the head fragment comes frome the anteromedial head portion. In external leg rotation these fragments must be on the anterior site to get refixed.

Surgical technique:

  1. incisione distal from the SIAS for about 10 cm
  2. osteotomy of the SIAS (not always necessary)
  3. section of the rectus femoris tendon: this is necessary to introduce later the screws for the head fragment fixation (screw direction from anteromedial to posteorlateral  - or straigth vertical) in maximal external leg rotation (nearby 90°). see video
  4. incision of hip capsule along the labrum border and T (along collum neck direction on the anterior side)
  5. riduction of the anteromedial fragment in external hip rotation
  6. temporary fixation with K-wires and then with screws (cancellous 4.0)
  7. capsue closure, refixation of rectus femoris tendon and SIAS

See surgical video of anterior approach and refixation of Pipkin fragment: link to OP video