CAJ | 학술논문

目的探讨常用的Pipkin分型对Pipkin骨折治疗和预后的指导意义.方法随访2002年1月-2007年1月治疗的Pipkin骨折患者71例,获得63例患者的详细资料.依据Thompson的临床和影像学评定标准对患者预后进行评定,分析获得结果,得出骨折类型的差异对Pipkin骨折预后的相关性影响,提出Pipkin分型对此种损伤预后的指导意义并完善Pipkin骨折的分型方法.结果Pipkin Ⅰ、Ⅱ型损伤与Pipkin Ⅰ、Ⅱ型损伤合并髋臼后缘小片骨折(骨折片宽度＜1 cm)的Pipkin Ⅳ型损伤预后差异无统计学意义(P＞0.05),Pipkin Ⅰ、Ⅱ型损伤与Pipkin Ⅰ、Ⅱ型损伤合并髋臼后壁骨折的Pipkin Ⅳ型损伤预后差异有统计学意义(P＜0.05).结论 Pipkin骨折的Pipkin分类方法应进一步得到完善.应借鉴Brumback分型方法,Pipkin Ⅰ、Ⅱ、Ⅲ型损伤合并髋臼后缘小片骨折(骨折片宽度＜1 cm)的Pipkin Ⅳ型损伤划归Pipkin Ⅰ、Ⅱ、Ⅲ型损伤.而Pipkin Ⅳ型损伤应指Pipkin Ⅰ、Ⅱ、Ⅲ型损伤合并髋臼后较大骨折片、髋关节不稳定型的损伤.此外,对于Pipkin骨折骨折线累及股骨颈和转子间区的特殊类型,临床治疗比较棘手,预后结果比较差,因此建议将此类损伤划为特殊的Pipkin Ⅲ型损伤.
목적 탐토상용적Pipkin분형대Pipkin골절치료화예후적지도의의.방법수방2002년1월-2007년1월치료적Pipkin골절환자71례,획득63례환자적상세자료.의거Thompson적림상화영상학평정표준대환자예후진행평정,분석획득결과,득출골절류형적차이대Pipkin골절예후적상관성영향,제출Pipkin분형대차충손상예후적지도의의병완선Pipkin골절적분형방법.결과Pipkin Ⅰ、Ⅱ형손상여Pipkin Ⅰ、Ⅱ형손상합병관구후연소편골절(골절편관도＜1 cm)적Pipkin Ⅳ형손상예후차이무통계학의의(P＞0.05),Pipkin Ⅰ、Ⅱ형손상여Pipkin Ⅰ、Ⅱ형손상합병관구후벽골절적Pipkin Ⅳ형손상예후차이유통계학의의(P＜0.05).결론 Pipkin골절적Pipkin분류방법응진일보득도완선.응차감Brumback분형방법,Pipkin Ⅰ、Ⅱ、Ⅲ형손상합병관구후연소편골절(골절편관도＜1 cm)적Pipkin Ⅳ형손상화귀Pipkin Ⅰ、Ⅱ、Ⅲ형손상.이Pipkin Ⅳ형손상응지Pipkin Ⅰ、Ⅱ、Ⅲ형손상합병관구후교대골절편、관관절불은정형적손상.차외,대우Pipkin골절골절선루급고골경화전자간구적특수류형,림상치료비교극수,예후결과비교차,인차건의장차류손상화위특수적Pipkin Ⅲ형손상.
Objective To assesses the value of the Pipkin fracture classification on the treatment and prognosis of Pipkin fracture. Methods A total of 71 patients with Pipkin fractures treated from January 2002 to January 2007 were followed up and the detailed information of 63 patients were obtained. The clinical and radiographic evaluation criteria of Thompson was employed to evaluate the outcome, analyze the results and discuss the correlation between Pipkin fracture type and prognosis and hence propose the significance of Pipkin classification on the prognosis. Results There was no statistical difference in aspect of the outcome between type Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with minimum fracture, with fragment ＜ 1 cm,P＞0. 05). There showed statistical difference in outcome between types Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with acetabular rim fracture, P ＜0. 05). Conclusions Pipkin fracture classification system needs a further improvement. The type Pipkin Ⅳ injury that is combined with types Pipkin Ⅰ , Ⅱ , Ⅲ injuries with minimum fracture (fragment ＜ 1 cm) of the acetabular rim should be incorporated into types Pipkin Ⅰ ,Ⅱ , Ⅲ injury. Type Pipkin Ⅳ injury refers to types Pipkin Ⅰ ,Ⅱ , Ⅲ injuries, with major fracture of the acetabular rim and the hip joint instability. In addition, the Pipkin fracture type involving the fracture line, femoral neck and intertrochanteric region is hard to treat clinically and has poor prognosis, suggesting that this type of injury should be considered as special type Pipkin Ⅲ injury.