Hip Pelvis.  2018 Jun;30(2):92-100. 10.5371/hp.2018.30.2.92.

Effectiveness of Hip Arthroscopy Performed Simultaneously before Open Reduction and Internal Fixation for Acetabular Fracture and Fracture-dislocation of the Hip

• Kim HJ
• Kim SS
• Jung YH
• Lee KH

• KMID: 2412690
• DOI: http://doi.org/10.5371/hp.2018.30.2.92

Abstract

PURPOSE
This study is performed to evaluate the usefulness of arthroscopic surgery prior to open reduction and fixation surgery to treat acetabular fractures and hip fractures-dislocation.
MATERIALS AND METHODS
From January 2010 to March 2014, a total of 54 patients with acetabular fractures or hip fractures with dislocation were treated arthroscopically via fracture surface before open reduction and fixation (group 1, n=11), and without hip arthroscopy prior to open reduction and fixation (group 2; n=43). Clinical results were evaluated using Harris hip score (HHS) and visual analogue scale (VAS) pain scores.
RESULTS
The mean age of patients is 43.2 years and there are 10 males and 1 females in group 1. The mean follow-up period is 15 months. The acetabular status of each case was assessed arthroscopically. Bone fragment was performed in 6 cases, and ligamentum teres shrinkage in 1 case. At the final follow up, the mean HHS and VAS pain scores were 78.6 and 2.18, respectively. During follow up, one case of osteoarthritis and one case of heterotopic ossification were identified. At the final follow up, the mean HHS and VAS pain scores were 77.5 and 2.23, respectively. In group 2, oteoarthritis and ectopic ossification were observed in 4 and 1 cases, respectively.
CONCLUSION
No differences were observed in the clinical outcomes of patients with acetabular fracture or hip fracture-dislocation when treated with or without arthroscopic surgery before open reduction and fixation. However, arthroscopy is thought to be useful for evaluating the joint cartilage surface and fracture fragments more accurately.

Keyword

Acetabulum; Acetabular fracture; Hip fractures; Hip dislocation; Arthroscopy

MeSH Terms

Acetabulum*
Arthroscopy*
Cartilage
Dislocations
Female
Follow-Up Studies
Hip Dislocation
Hip Fractures
Hip*
Humans
Joints
Male
Ossification, Heterotopic
Osteoarthritis
Round Ligaments

Figure

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  Fig. 1 (A) Posterior wall fracture and bone fragment in right hip joint was seen at preoperative X-ray, (B) computed tomography (CT), and (C) three-dimentional CT.

• 

  Fig. 2 (A) Femoral head was posterior dislocated. (B) Reduction was done. (C) Posterior wall fracture and bone fragment was seen in preoperative computed tomography (CT) and (D) three-dimensional CT.

• 

  Fig. 3 Intraoperative arthroscopic finding, injured acetabular cartilage, labrum and bone fragment was seen.

• 

  Fig. 4 Intraoperative arthroscopic finding, (A) Acetabular fracture gap was seen. (B) Injured acetabular cartilage was seen.

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  Fig. 5 (A) Plate fixation was seen in postoperative radiography. (B) Specific abnormal change was not seen in follow up radiography.

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  Fig. 6 (A) Plate fixation was seen in postoperative radiography. (B) Specific abnormal change was not seen in follow up radiography.

• 

  Fig. 7 (A) Left hip fracture and dislocation was seen in preoperative radiography. (B) Open reduction and internal fixation was done. (C) After 2 years, osteoarthric change was checked. (D) Total hip arthroplasty was done.

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