Traumatic Hip Dislocations in an Orthopedic Center in Lagos

Hip dislocations are one of the orthopedic emergencies. They may result from a high-energy transfer as in a road traffic crash. Prompt recognition and treatment can reduce the long-term morbidity associated with delayed reduction. The goal of this study was to evaluate the epidemiology and outcome of treatment.

This was a retrospective study that involved cases of traumatic hip dislocations seen at the National Orthopedic Hospital, Lagos, Nigeria, between January 1, 2010 and June 30, 2014. Biodemographic characteristics, mechanism of injury, and type of dislocations were retrieved from case files. Thompson and Epstein type of the dislocated hips as well as the presence of pre- and post-reduction complications was noted.

Forty-five patients had hip dislocations in the study period. Only 27 had the relevant information to be included in the study. All cases were posterior hip dislocations. The median follow-up was 9 months (range 6-30 months). More dislocations occurred on the left [18 (67.0%)] than on the right [9 (33.0%)]. The median age of patients was 37 years (range 21-73 years). Twenty-six dislocations (96.3%) were due to road traffic crash and a case (3.7%) was due to an industrial accident. Grade IV Epstein was the most common injury recorded. Twenty-four (89.0%) cases were managed with closed reduction, whereas the remaining 3 (11.0%) cases had open reduction. The associated complications observed were sciatic nerve injury, avascular necrosis of the head of the femur, and protrusio acetabuli.

Road traffic crash remains a leading cause of traumatic hip dislocation. Severity of injury and delay in reduction contributes to the complications of treatment.