Abstract
OBJECTIVE: To compare the efficacy of Ganz approach and Kocher-Langenbeck (K-L) approach in Pipkin type IV femoral head fracture (FHF) with internal fixation. METHODS: The medical records of patients with Pipkin type IV FHF were assessed in the observational study. The patients were divided into Ganz approach group and K-L approach group. The surgical time, intraoperative blood loss, quality of acetabular fracture reduction, Thompson-Epstein clinical and radiological score, fracture healing time, Harris hip score, and complications were recorded. RESULTS: Fifteen patients were followed for 12–23 months (mean 16.8 months). The Ganz approach group showed significantly better Thompson-Epstein clinical and radiological scores (7 excellent, 1 good) than the K-L group (2 excellent, 5 good) (P < 0.05). According to Matta radiographic criteria, anatomical reduction was achieved in 6 cases (with 2 satisfactory) in the Ganz group compared to 5 cases (with 2 satisfactory) in the K-L group, demonstrating a non-significant trend toward superiority for the Ganz approach (P > 0.05). CONCLUSION: Compared with the traditional K-L approach, the Ganz approach offers better visual field exposure, better reduction quality of FH, and better postoperative functional recovery.