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[Factors affecting the results of treatment in traumatic dislocation of the hip]
Oğuz Durakbaşa1, Nedret Okan, Kerem Canbora
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Kliniği), Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. odurakbasa@yahoo.com
Objectives:
We evaluated the long-term results of conservative and surgical treatment and the effect of prognostic factors on these results in patients with traumatic dislocation of the hip.
Methods:
The study included 30 patients (27 males, 3 females; mean age 35 years; range 16 to 69 years) with traumatic hip dislocations. The most common cause was traffic accidents (80%). Fifteen patients underwent closed reduction for posterior (n=10), anterior (n=2), and central (n=3) dislocations, of which eight were isolated and seven were fracture dislocations. Open reduction was performed in 15 patients with posterior (n=14) and central (n=1) dislocations. Of these, five patients had isolated hip trauma and 10 patients had multiple trauma. Surgery was performed within the first 24 hours (n=6) or between five and 21 days (n=9). Posterior, central, and anterior dislocations were classified according to the Thompson-Epstein, Judet, and Epstein classification systems, respectively. The Pipkin classification was also used for dislocations with femoral head fractures. The results were evaluated according to the criteria proposed by Matta. The mean follow-up was 49 months (range 16 to 84 months).
Results:
Following closed reduction, the results were satisfactory (very good or good) in 11 patients (73.3%, all isolated dislocations and three posterior fracture dislocations) and unsatisfactory (moderate or poor) in four patients (26.7%). Following open reduction, nine patients (60%) with posterior fracture dislocations had satisfactory and six patients (40%) had unsatisfactory outcome. The results were unsatisfactory in all the central dislocations. One patient developed avascular necrosis of the femur head and four patients developed degenerative arthritis following closed reduction. Degenerative arthritis was seen in six patients after surgical treatment, two of whom also had avascular necrosis.
Conclusion:
Our data may provide insight into the factors affecting the prognosis of traumatic hip dislocations treated by closed or open reduction.
