Neglected traumatic hip dislocation: Influence of the increased intracapsular pressure

To investigate that the increased intracapsular pressure, during the delay period, can interrupt the blood flow to the femoral head.

An observational retrospective study included a group of 17 patients with traumatic hip dislocation, their ages at time of injury averaged 26 (range from 3 to 70) years. Outcomes were assessed clinically and radiographically at a period averaged 11.5 (range from 4 to 20) years.

Minor trauma caused dislocation in seven and severe trauma in ten patients. All dislocations were posterior, six isolated dislocation and 11 were associated with other injuries. The negligence period averaged 2.5 (ranged from 1 to 4) d. At the latest visit, the radiography revealed normal hip in 11 and avascular necrosis (AVN) in six patients. Clinically, eight patients were rated as excellent, three good, three fair and three poor.

We believe the factors that contribute to increased intracapsular pressure also increase the influence of delayed reduction toward the development of AVN.