Late versus early reduction in traumatic hip dislocations: a meta-analysis
Ghalib Ahmed1, Salman Shiraz1, Muhammad Riaz1,2
1Section of Orthopedics, Department of Surgery, Hamad General Hospital, PO Box 3050, Doha, Qatar.
Summary
Urgent reduction of traumatic hip dislocations within 6 hours significantly lowers the risk of osteonecrosis of the femoral head. This study found no link between dislocation grade and osteonecrosis rates.
Area of Science:
- Orthopaedic Surgery
- Traumatology
- Radiology
Background:
- Traumatic hip dislocation is an orthopaedic emergency requiring prompt treatment.
- Delayed reduction increases the risk of osteonecrosis of the femoral head (ONFH).
Purpose of the Study:
- To systematically review and compare the outcomes of early (<6 hours) versus late (>6 hours) reduction of traumatic hip dislocations.
- To assess the impact of reduction timing on the incidence of ONFH.
Main Methods:
- A meta-analysis of five retrospective cohort studies (236 dislocations) was performed.
- Studies were identified through searches of five databases (1951-2016).
- Odds ratios (ORs) were calculated to compare ONFH rates between early and late reduction groups.
Main Results:
- Early hip reduction was associated with a significantly lower rate of ONFH (OR = 5.00, 95% CI: 1.30, 19.29).
- No significant difference in ONFH rates was observed between low- and high-grade traumatic hip dislocations based on the time threshold (OR = 1.71, 95% CI: 0.22, 13.22).
Conclusions:
- Current evidence indicates that late hip reduction is associated with a higher incidence of ONFH in traumatic hip dislocations.
- Prompt reduction of all traumatic hip dislocations is recommended to minimize ONFH risk.
- The grade of dislocation does not appear to influence the rate of ONFH.
