مرکز منطقه ای اطلاع رساني علوم و فناوري - Factors affecting the results of treatment in traumatic dislocation of the hip

Latin Abstract :

Obj e ctive s : We evaluated the long-term results of conservative and surgical treatment and the effect of prognostic factors on these results in patients with traumatic dislocation of the hip. M e tho ds : The study included 30 patients (27 males, 3 females; mean age 35 years; range 16 to 69 years) with traumatic hip dis¬locations. The most common cause was traffic accidents (80%). Fifteen patients underwent closed reduction for posterior (n=10), anterior (n=2), and central (n=3) dislocations, of which eight were isolated and seven were fracture dislocations. Open reduction was performed in 15 patients with posterior (n=14) and central (n=1) dislocations. Of these, five patients had isolated hip trauma and 10 patients had multiple trauma. Surgery was performed within the first 24 hours (n=6) or between five and 21 days (n=9). Posterior, central, and anterior dislocations were classified according to the Thompson-Epstein, Judet, and Epstein classification systems, respectively. The Pipkin classification was also used for disloca¬tions with femoral head fractures. The results were evaluated according to the criteria proposed by Matta. The mean follow-up was 49 months (range 16 to 84 months). Resu lts : Following closed reduction, the results were satisfac¬tory (very good or good) in 11 patients (73.3%, all isolated dis¬locations and three posterior fracture dislocations) and unsat¬isfactory (moderate or poor) in four patients (26.7%). Following open reduction, nine patients (60%) with posterior fracture dislocations had satisfactory and six patients (40%) had unsatisfactory outcome. The results were unsatisfactory in all the central dislocations. One patient developed avascular necrosis of the femur head and four patients developed degen¬erative arthritis following closed reduction. Degenerative arthritis was seen in six patients after surgical treatment, two of whom also had avascular necrosis. Conclusion: Our data may provide insight into the factors affecting the prognosis of traumatic hip dislocations treated by closed or open reduction.