نتايج درمان دررفتگي پشتي مفصل ران همراه با شكستگي ديواره پشتي استابولوم (مقايسه روش جراحي و غيرجراحي)

Treatment Outcome of Posterior Dislocation of Hip Associated with Acetabular Fracture (A Comparative Study between Surgical and Nonsurgi cal Treatment)

Background: Fracture dislocation of the hip is a result of high energy trauma and can lead to hip dysfunction and patient disability. Stable and perfect reduction of the fem oral head and acetabular wall are the two most important prognostic factors . The aim of this study was to compare the resulrs of surgical treatment with nonsurgical treatment in this injury . Methods: In a period of 2 years, the cases of posterior hip dislocation with acetabular rim fractur e were studied, Two groups were recognized after closed reduction of dislocation. First group (18 patients) received open reduction and platin g of acetabular fracture followed by 3-5 weeks of skeleta l traction. The second group (J4 patients) was treated by skeleta l traction of 5-6 weeks . The patients werc evaluated lor hip motion, stability, complications or nerve injury and early osteoarthritis, and ac etabular fracture index in average one year follow-up . Th e results were eompared in the two groups. Results: Restriction of hip motion was more common in nonsurgic al paLients. Sciatic ncrve injwy was noted in 3 patients of surgical group with recovery in 2 of them. Perfect reduction was seen in 17 (94.4%) of surgica l and 9 (64.3%) of nonsurgical patients. Primaryoste oarthritis was seen in 7 patients (38.9%) o f surgica l and 8 patients (57%) o f nonsurgical group . AFI in surgical and nonsurgical groups were 55.2% and 32.5% respectively. Surg ical patients had bctter functional result s. Conclusion: Articular damage by initial trauma, perfect reduction of the hip and stable anatomic fixation of the acetabular wall are the important prognostic factors. The patients with surgical treatm ent obtain better functional outcome.