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Related Experiment Videos

Posterior hip dislocations: a cadaveric angiographic study

J J Yue1, J H Wilber, J P Lipuma

  • 1Department of Orthopaedic Surgery, Case Western Reserve University Medical School/Metrohealth Medical Center, Cleveland, Ohio, USA.

Journal of Orthopaedic Trauma
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

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Traumatic posterior hip dislocation can disrupt blood flow to the femoral head, potentially causing avascular necrosis (AVN). This study found significant changes in femoral and circumflex vessels, but intraosseous flow was often preserved by collateral circulation.

Area of Science:

  • Orthopedic Surgery
  • Vascular Anatomy
  • Trauma Medicine

Background:

  • Avascular necrosis (AVN) of the femoral head is a known complication of traumatic posterior hip dislocation.
  • The precise vascular mechanisms leading to AVN in these cases remain incompletely understood.
  • Previous studies have hypothesized blood flow disruption, but direct cadaveric angiographic evidence is lacking.

Purpose of the Study:

  • To investigate the effects of posterior hip dislocation on the extraosseous and intraosseous blood supply of the femoral head and neck in human cadavers.
  • To identify specific vessels affected by the dislocation and assess the impact on blood flow.
  • To correlate vascular changes with the potential development of AVN.

Main Methods:

  • Six fresh frozen human cadavers underwent induced posterior hip dislocation.

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  • Proximal vessels were injected with Microfil (a radioopaque polymer) for cinefluoroscopic examination.
  • Contralateral hips served as controls.
  • Macroscopic and microscopic examinations were performed on harvested hips.

    • Main Results:

    • Significant filling defects were observed in the common femoral and circumflex arteries of dislocated hips compared to controls (p < 0.004).
    • These defects were attributed to arterial stretching and twisting caused by the dislocation.
    • While extraosseous blood flow changes were evident, intraosseous flow was not consistently affected, suggesting a role for collateral circulation.

    Conclusions:

    • Posterior hip dislocation causes significant alterations in extraosseous blood flow, primarily affecting the common femoral and circumflex vessels.
    • Collateral circulation may preserve intraosseous blood flow, potentially mitigating the risk of AVN.
    • Prompt relocation of the femoral head is crucial to restore blood flow and minimize ischemic damage, while delayed relocation may increase AVN risk.