Hip Pelvis.  2013 Mar;25(1):57-65. 10.5371/hp.2013.25.1.57.

Traumatic Dislocation of the Hip with a Femoral Head Fracture

• Sung YB
• Choi JY
• Kim JW

• KMID: 1425037
• DOI: http://doi.org/10.5371/hp.2013.25.1.57

Abstract

PURPOSE
This study was designed in order to evaluate the clinical results and frequency of complications of patients who underwent surgical treatment for traumatic dislocation of the hip with a femoral head fracture.
MATERIALS AND METHODS
Eighteen cases of Thompson-Epstein type V femoral head fracture with dislocation of the hip from November 2002 to November 2011 were analyzed retrospectively. We divided the cases into two groups according to availability of closed reduction and reduction time, and analyzed the clinical results according to Epstein criteria and frequency of avascular necrosis of the femoral head and posttraumatic osteoarthritis.
RESULTS
Among all patients, the observed complications included three cases of avascular necrosis and one case of posttraumatic osteoarthritis. The data showed that 14 cases were available for closed reduction; otherwise, there were four cases of failure. Significant differences were observed in clinical results and frequency of complications. Results regarding reduction time showed that 10 cases took 6 hours, and the other eight cases took more than 6 hours. There were no differences in clinical results, but, better results were achieved with a reduction time in 6 hours. However, significant differences were observed in frequency of complications.
CONCLUSION
The availability of closed reduction would be an important factor for achievement of good clinical results in traumatic dislocation of the hip with a femoral head fracture. In order to obtain better clinical results, closed reduction should be performed as rapidly as possible.

Keyword

Femoral head fracture; Dislocation of the hip; Thompson-Epstein type V

MeSH Terms

Achievement
Dislocations
Head
Hip
Humans
Necrosis
Osteoarthritis
Retrospective Studies

Figure

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  Fig. 1 (A, B) A 23-year-old male sustained Pipkin type I fracture of hip. (C, D) Open reduction and internal fixation of femoral head with trochanter flip osteotomy was done. The radiograph and CT at postoperative 20 months shows complete healing of the fracture, and there is no evidence of avascular necrosis of femoral head or post-traumatic osteoarthritis.

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  Fig. 2 (A, B) A 71-year-old male sustained Pipkin type IV fracture of hip. (C) Open reduction and internal fixation of acetabulum with spring plate and screws through the Kocher-Langenbeck approach was done. (D, E) The radiograph and CT at postoperative 2 months shows neglected posterior dislocation of hip. (F, G) Bipolar hemiarthroplasty of hip was done. The radiograph at postoperative 30 months shows well maintained prosthesis.

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  Fig. 3 (A, B) A 42-year-old male sustained Pipkin type IV fracture of hip. (C) Open reduction and internal fixation with reconstruction plate and screws through the Kocher-Langenbeck approach with trochanter flip osteotomy. (D) The radiograph at postoperative 21 months shows avascular necrosis of femoral head and osteoarthritis change on the joint. (E, F) Total hip arthroplasty was done. The radiograph at postoperative 96 months shows stable fixation of cup and stem.

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