Complications after posterior dislocation of the hip

Area of Science:

• Orthopedic Surgery
• Traumatology

Background:

• Unilateral posterior hip dislocation is a severe injury.
• Thompson-Epstein type IV dislocations are increasingly frequent due to high-speed motor vehicle accidents in developing nations.

Purpose of the Study:

• To investigate the complications associated with unilateral posterior hip dislocations.
• To analyze the correlation between dislocation type and complication rates.

Main Methods:

• Prospective study of 35 consecutive patients with unilateral posterior hip dislocation.
• Average follow-up of 4.6 years (range 2-10 years).
• Classification of dislocations using the Thompson-Epstein system.

Main Results:

• Thompson-Epstein type IV dislocations were most frequent (10/35) and associated with the highest complication rates.
• Complications included avascular necrosis, osteoarthritis, sciatic nerve injury, and heterotrophic ossification.
• Avascular necrosis and osteoarthritis were maximal in type IV patients, even with early reduction.
• Heterotrophic ossification occurred in 50% of type IV cases, linked to multiple reduction attempts.
• Incomplete sciatic nerve recovery was noted, particularly with delayed reduction (>12 hours).

Conclusions:

• Thompson-Epstein type IV hip dislocations represent a severe injury with a high risk of complications.
• Prognosis for type IV dislocations, including avascular necrosis and nerve injury, should be clearly communicated to patients.
• Severity of initial injury appears to be a key factor in long-term outcomes.