Native hip dislocation at acetabular fracture predicts poor long-term outcome.

Area of Science:

• Orthopedic surgery
• Trauma care
• Hip joint biomechanics

Background:

• Acetabular fractures are complex injuries.
• Posterior hip dislocation can occur concurrently with acetabular fractures.
• Long-term outcomes of these combined injuries are not well-defined.

Purpose of the Study:

• To compare long-term clinical outcomes and complications.
• To evaluate acetabular fractures with posterior hip dislocation versus those without.
• To identify risk factors for adverse outcomes.

Main Methods:

• Retrospective cohort study of 113 patients with acetabular fracture-dislocations and 367 controls.
• Data collected on patient characteristics, complications, reoperations, and total hip arthroplasty (THA).
• Long-term patient-reported outcomes (Oxford Hip Score, SF-12) assessed at a mean of 9.7 years.

Main Results:

• Patients with dislocations were younger, male, with higher Injury Severity Scores (ISS).
• Higher rates of sciatic nerve palsy (12% vs 1%) and avascular necrosis (AVN) (11% vs 1%) in the dislocation group.
• Worse 10-year native hip survival (75.1% vs 90.7%) and lower long-term Oxford Hip Scores in the dislocation group.

Conclusions:

• Acetabular fractures with associated posterior hip dislocation result in poorer long-term functional outcomes.
• These injuries are linked to increased complication rates, including AVN and nerve palsy.
• Higher rates of conversion to THA are observed in patients with fracture-dislocations.