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

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

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Chinese Journal of Clinical Anatomy ›› 2026, Vol. 44 ›› Issue (4) : 469-475. DOI: 10.13418/j.issn.1001-165x.2026.4.15

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*

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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.

Key words

Pipkin fracture / / / Acetabular posterior wall fracture / / / Femoral head fracture / / / Reduction and internal fixation

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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

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