{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:16:16Z","timestamp":1788315376013,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hip arthroscopy\u2013assisted surgery has been proposed as a minimally invasive option for femoral head fractures; however, evidence with mid\u2010term follow\u2010up remains limited. This study aimed to evaluate the clinical and radiographic outcomes of arthroscopy\u2010assisted management for Pipkin Types I and II femoral head fracture\u2013dislocations with a minimum follow\u2010up of 5\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 23 consecutive adults (19 Pipkin I and 4 Pipkin II) treated with hip arthroscopy\u2013assisted fragment excision or internal fixation between March 2013 and January 2020. Preoperative computed tomography was used for surgical planning, and fixation was placed with arthroscopic headless screws. Clinical outcomes were assessed using the Harris Hip Score (HHS) and Thompson\u2013Epstein (T\u2013E) criteria. Radiographic evaluation included avascular necrosis (AVN), heterotopic ossification (HO; Brooker), osteoarthritis (OA; T\u00f6nnis), and fracture reduction quality (Matta's criteria). Group comparisons were evaluated using independent samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, and Fisher's exact test. The mean follow\u2010up was 86.2\u2009\u00b1\u200921.2\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort consisted of 19 males and 4 females with a mean age of 28.7\u2009\u00b1\u20099.9\u2009years. Fifteen patients underwent fixation and eight underwent excision. The final mean HHS was 98.3\u2009\u00b1\u20091.9, with 21 patients (91%) achieving excellent and 2 (9%) good T\u2013E criteria. There were no significant differences between the fixation and excision groups in demographic characteristics, operative time, or functional outcomes (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05); however, hospital stay was significantly shorter in the excision group (2.9\u2009\u00b1\u20090.6 vs. 5.5\u2009\u00b1\u20094.6\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). In the fixation group, mean maximal displacement improved from 7.6\u2009mm preoperatively to 2.6\u2009mm postoperatively, with anatomic reduction achieved in 6 cases (40%), imperfect in 6 (40%), and poor in 3 (20%). Patients with Pipkin Type I fractures had significantly higher HHS than those with Type II fractures (98.7\u2009\u00b1\u20091.7 vs. 96.0\u2009\u00b1\u20090.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Complications were rare, with one case of Brooker Grade I HO and one case of mild OA. No AVN or total hip arthroplasty occurred during the follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hip arthroscopy\u2013assisted management of selected Pipkin Type I and II femoral head fractures yields excellent mid\u2010term clinical outcomes with acceptable radiographic reduction and a low complication rate. This minimally invasive technique represents a viable alternative in appropriately selected patients when fragment characteristics and surgical expertise permit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70387","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:02:01Z","timestamp":1786950121000},"page":"1861-1870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hip Arthroscopy\u2013Assisted Management of Pipkin Types I and\n                    <scp>II<\/scp>\n                    Femoral Head Fracture\u2013Dislocations: Mid\u2010Term Clinical and Radiographic Outcomes"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-2241","authenticated-orcid":false,"given":"Shan\u2010Ling","family":"Hsu","sequence":"first","affiliation":[{"name":"The Department of Orthopaedic Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Hsiang","family":"Hsu","sequence":"additional","affiliation":[{"name":"The Department of Orthopaedic Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin\u2010Yi","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Kaohsiung Municipal Fong Shan Hospital\u2013Under the Management of Chang Gung Medical Foundation  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-010-1087-4"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20110317-09"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.11.007"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.6.210034"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-023-00846-1"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-023-06317-w"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2016.05.001"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.11.027"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnad002"},{"issue":"8","key":"e_1_2_13_11_1","first-page":"1629","article-title":"Ectopic Ossification Following Total Hip Replacement. Incidence and a Method of Classification","volume":"55","author":"Brooker A. F.","year":"1973","journal-title":"Journal of Bone and Joint Surgery. 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