Severity of injuries associated with traumatic hip dislocation as a result of motor vehicle collisions

Previous reports have shown a high rate of associated injuries in patients who sustain traumatic hip dislocation. Since these earlier reports appeared, improvements have been made in passenger safety systems and the rate of restraint usage has increased. The purpose of this study was to review the associated injuries present in a current series of patients who sustained traumatic hip dislocation as a result of motor vehicle collisions.

We retrospectively reviewed our trauma registry and identified 66 patients who sustained traumatic hip dislocation as a result of motor vehicle collisions. Thirty patients (45%) were restrained and 36 (55%) were unrestrained. Airbags were known to have deployed in 14 cases.

The incidence of associated injuries was 95% (63 patients). Orthopedic injuries alone were seen in 22 patients (33%), whereas associated injuries were seen in 44 patients (67%). Abdominal injuries were present in 10 patients (15%), thoracic injuries were present in 14 patients (21%), closed head injuries were present in 16 patients (24%), and craniofacial injuries were present in 14 patients (21%). Acetabular fractures were seen in 46 patients (70%), femoral head fractures were identified in 9 patients (14%), and other extremity fractures occurred in 26 patients (39%). The average Injury Severity Score for all patients was 17.4 (range, 9-59). The average Injury Severity Score of the restrained patients was not statistically different from that of the unrestrained patients (p = 0.491).

Although improvements in automotive safety features and restraint usage have occurred since previous reports appeared, there continues to be a high rate of severe injuries associated with traumatic hip dislocation that occur in motor vehicle collisions. We believe that all patients who sustain traumatic hip dislocation warrant a general surgery trauma evaluation to rule out any potential associated injuries.