Ganz入路治疗Pipkin Ⅳ型股骨头骨折脱位合并髋臼后壁骨折临床疗效

doi:10.13418/j.issn.1001-165x.2026.4.15

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中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (4) : 469-475. DOI: 10.13418/j.issn.1001-165x.2026.4.15

临床研究

Ganz入路治疗Pipkin Ⅳ型股骨头骨折脱位合并髋臼后壁骨折临床疗效

陈林，罗兰，张旭林，李磊，刘东*

作者信息 +

Clinical efficacy of the Ganz approach in the treatment of Pipkin type IV femoral head fracture dislocation combined with posterior acetabular wall fracture

Chen Lin, Luo Lan, Zhang Xulin, Li Lei, Liu Dong*

Author information +

文章历史 +

摘要

目的探讨采用Ganz入路（髋关节外科脱位入路）治疗Pipkin Ⅳ型股骨头骨折的临床疗效。方法回顾2021年1月至2024年2月采用Ganz入路治疗8例Pipkin Ⅳ型股骨头骨折患者，采集手术时间、术中出血量、骨折愈合时间及术后并发症等数据，以髋关节Harris评分评估术前和术后12月髋关节功能。结果 8例患者均顺利完成手术，其中2例患者因髋臼后壁骨折块较小予以保守治疗髋臼后壁骨折。术中出血150~450 mL，平均（318.7±96.1） mL；手术时间140~170 min，平均（151.2±10.3） min，Matta评价指标评估骨折复位满意。术后随访12~45月，平均（18.8±10.1）月。术前及术后12月髋关节Harris评分分别为（50.5±7.8）分和（89.6±4.3）分，差异有统计学意义（P<0.05）。复查X线片示大转子截骨及股骨头和髋臼骨折均达到骨性愈合，均未发生骨不连、髋关节异位骨化及股骨头缺血坏死等并发症。结论 Ganz入路治疗Pipkin Ⅳ型股骨头骨折，既能充分暴露髋关节及股骨头，又能保证股骨头血供，减少股骨头缺血坏死发生，临床效果满意，值得推广。

Abstract

Objective To explore the clinical effect of Ganz approach (surgical dislocation approach of hip joint) in the treatment of Pipkin Ⅳ femoral head fracture. Methods From January 2021 to February 2024, 8 patients with Pipkin Ⅳ femoral head fracture were treated by Ganz approach. The operation time, intraoperative blood loss, fracture healing time and postoperative complications were recorded. Harris hip score was used to evaluate the functional recovery of hip joint before operation and one year after operation. Results All 8 patients were successfully completed the operation, and 2 of them were treated conservatively because the fracture of acetabular posterior wall was too small. The intraoperative blood loss was (150-450) mL, with an average of (318.7±96.1) mL. The operation time was (140-170) min, with an average of (151.2±10.3) min. Matta evaluation index was used to evaluate the satisfaction of fracture reduction. Eight patients were followed up for (12-45) months with an average of (18.8±10.1) months. Harris score of hip joint before operation and one year after operation was (50.5±7.8) and (89.6±4.3), respectively. The difference was statistically significant (P<0.05). X-ray reexamination showed that the osteotomy of greater trochanter and the fractures of femoral head and acetabulum all achieved bone healing, and no complications such as nonunion, heterotopic ossification and avascular necrosis of femoral head occurred. Conclusions Ganz approach in the treatment of Pipkin type IV femoral head fracture can not only fully expose the hip joint and femoral head, but also protect the blood supply of femoral head and reduce the occurrence of avascular necrosis of femoral head. The clinical effect is satisfactory and it is worthy of clinical promotion.

导出引用

陈林, 罗兰, 张旭林, 李磊, 刘东. Ganz入路治疗Pipkin Ⅳ型股骨头骨折脱位合并髋臼后壁骨折临床疗效[J]. 中国临床解剖学杂志. 2026, 44(4): 469-475 https://doi.org/10.13418/j.issn.1001-165x.2026.4.15

Chen Lin, Luo Lan, Zhang Xulin, Li Lei, Liu Dong. Clinical efficacy of the Ganz approach in the treatment of Pipkin type IV femoral head fracture dislocation combined with posterior acetabular wall fracture[J]. Chinese Journal of Clinical Anatomy. 2026, 44(4): 469-475 https://doi.org/10.13418/j.issn.1001-165x.2026.4.15

中图分类号： R322.72 R687.4

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