Management of femoral head fracture by Ganz surgical dislocation of the hip

Hossam Hosny; Shazly Mousa; Wael Salama

doi:10.1186/s10195-022-00643-w

Management of femoral head fracture by Ganz surgical dislocation of the hip

J Orthop Traumatol. 2022 May 10;23(1):24. doi: 10.1186/s10195-022-00643-w.

Authors

Hossam Hosny¹, Shazly Mousa², Wael Salama²

Affiliations

¹ Orthopedic and Traumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt. hossamhusny@med.sohag.edu.eg.
² Orthopedic and Traumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

Abstract

Introduction: Posterior hip dislocation is the commonest type of hip dislocation. It is associated with femoral head fracture in 7% of cases. Urgent and congruent hip reduction is mandatory to improve clinical outcomes and avoid irreversible complications. The purpose of this study is to assess the safety and functional and radiological outcomes of surgical hip dislocation by Ganz technique for treatment of femoral head fracture.

Patients and methods: In this retrospective study, 18 cases of femoral head fracture were included. Six cases had Pipkin type I and 12 had Pipkin type II fracture. They were treated through surgical hip dislocation. All cases were followed up for at least 24 months. Matta's criteria were used for radiological evaluation (plain radiographs). Functional evaluation was done using Harris Hip Score and modified Merle d'Aubigne and Postel score at final follow-up.

Results: No patients were lost during the follow-up period. No signs of infection or wound dehiscence were noted in this study. There was one case of osteonecrosis. All cases had labral injury, which was debrided. None of our cases needed suture anchor repair of the labrum. Radiographical evaluation according to Matta's criteria yielded anatomic fracture reduction in 17 patients but imperfect in 1 patient. According to Harris Hip Score, four Pipkin type I cases were rated as excellent and two as good. Among cases of Pipkin type II fracture, six were rated as excellent, four as good, one as fair, and one as poor. According to modified Merle d'Aubigne and Postel score, 11 cases had excellent results, 5 cases were rated as good, one as fair, while one case had poor results.

Conclusion: Open reduction and internal fixation of femoral head fracture using surgical hip dislocation through Ganz approach is a viable treatment option and provides satisfactory results with low complication rate.

Keywords: Femoral head fracture; Femoral head osteonecrosis; Ganz technique; Hip dislocation; Pipkin classification; Trochanteric flip osteotomy.

MeSH terms

Femoral Fractures* / surgery
Femur Head / diagnostic imaging
Femur Head / injuries
Femur Head / surgery
Fracture Fixation, Internal / methods
Hip Dislocation* / diagnostic imaging
Hip Dislocation* / etiology
Hip Dislocation* / surgery
Hip Fractures* / complications
Hip Fractures* / diagnostic imaging
Hip Fractures* / surgery
Humans
Retrospective Studies
Treatment Outcome