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Hip dislocations and concurrent injuries in motor vehicle collisions
Joseph Cooper1, Justin Tilan2, Alexis D Rounds3
1Department of Orthopedic Surgery, Keck School of Medicine of University of Southern California, 1520 San Pablo St, Suite 2000, Los Angeles, CA, 90033, United States.
Injury
|May 10, 2018
Summary
Motor vehicle collisions causing hip dislocations remain high-energy events with severe injuries. Restraint devices, particularly seatbelts with airbags, offer protection against pelvic and lumbar fractures but increase upper extremity risks.
Area of Science:
- Trauma surgery
- Orthopedic surgery
- Emergency medicine
Background:
- Motor vehicle collisions (MVC) can result in high-energy hip dislocations with severe injury profiles.
- Modern safety and restraint device regulations may have altered previously reported injury patterns.
Purpose of the Study:
- To describe the contemporary injury profile of patients experiencing traumatic hip dislocations following MVC.
- To specifically investigate the occurrence of aortic injuries in this patient cohort.
Main Methods:
- Retrospective review of a prospectively maintained trauma database (January 2005 - December 2015).
- Patients with hip dislocations from MVC were stratified by seatbelt use and airbag deployment.
- Logistic regression analysis identified injury risk profiles associated with different restraint conditions.
Main Results:
- Nearly 57% of 204 patients with hip dislocation after MVC were unrestrained.
- Seatbelt and airbag use in combination was protective against pelvic ring injury (OR=0.22).
- Airbag deployment protected against lumbar fractures (OR=0.15) but increased risks for radial/ulnar fractures (OR=3.27), acetabular fractures (OR=5.19), and abdominopelvic injuries (OR=5.07).
- One unrestrained patient sustained a thoracic aortic intimal tear, managed successfully.
Conclusions:
- Hip dislocations from MVC are severe injuries associated with significant concomitant injuries, irrespective of restraint device advancements.
- Thorough patient evaluation for associated injuries is crucial, with heightened awareness for specific injury patterns based on restraint use.
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