Comparison of clinical efficacy of Ganz approach and K-L approach in treatment of Pipkin type IV femoral head fracture

To compare the efficacy of Ganz approach and Kocher-Langenbeck (K-L) approach in Pipkin type IV femoral head fracture (FHF) with internal fixation. 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. 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). 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.