Posterior Hip Dislocation with Femoral Head and Neck Fracture

Suh, You Sung; Lee, Jae Hoon; Yim, Soo Jae; Kim, Yon Il

Abstract

PURPOSE: In the femoral head fracture associated with posterior dislocation of hip, we analyzed the clinical results according to the fracture types and treatment methods to promoting the guide of treatment.
MATERIALS AND METHODS
We used 20 cases of fractured femoral head with posterior dislocation of hip from January 1990 to December 1997, and analyzed the treatment methods and clinical results according to the Pipkin classification.
RESULTS
Among the 20 cases, male was 19 cases(95%), motor vehicle accident contributed 15 cases(75%), and the case of type II and IV of Pipkin classification were 7(35%) and 9(45%) cases. Closed reduction performed within 12 hours after injury with good results was conducted in 9 cases(60%) among the 15 cases. According to the treatment methods after closed reduction, good result was showed only 3 of 8 cases(37.5%) in the conservative treatment, whereas 8 of 12 cases(66.7%) in the operative treatment. According to the type of Pipkin classification, good result was showed 3 of 6 cases(50%) in conservative treatment and all of 3 cases in operative treatment among the 9 cases of type I and II, whereas none of 2 cases in conservative treatment and 5 of 9 cases(56%) in operative treatment among the 11 cases of type III and IV. The following complications were encounted; 2 cases of avascular necrosis, 1 case of traumatic arthritis, 1 case of peroneal nerve palsy and 1 case of nonunion
CONCLUSION
Good results were obtained in patients with early, stable, and accurate reduction. The Computed Tomogram was helpful to find the small fragment and check the accurate reduction. Open method that restoration joint congruity seemed to be the better procedure than closed method.