Factors affecting the results of teratment in traumatic dislocation of the hip

Objective & Hypothesis:Objectives: 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.

📊

Key Findings & Data:Methods: The study included 30 patients (27 males, 3 females; mean age 35 years; range 16 to 69 years) with traumatic hip dislocations.

💡

Conclusion & Impact:Conclusion: Our data may provide insight into the factors affecting the prognosis of traumatic hip dislocations treated by closed or open reduction.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Kalça kırıkları · Kalça çıkığı · Tomografi

Abstract

Objectives: 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. Methods: The study included 30 patients (27 males, 3 females; mean age 35 years; range 16 to 69 years) with traumatic hip dislocations. 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=l) 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 dislocations 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). Results: Following closed reduction, the results were satisfactory (very good or good) in 11 patients (73.3%, all isolated dislocations and three posterior fracture dislocations) and unsatisfactory (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 degenerative 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.

Özet

Amaç: Konservatif veya cerrahi yöntemlerle tedavi edilen travmatik kalça çıkıklı olgularda geç dönem izlem sonuçları ve bu sonuçlan etkileyen prognostik faktörler değerlendirildi. Çalışma planı: Travmatik kalça çıkığı nedeniyle 30 hastanın (27 erkek, 3 kadın; ort. yaş 35; dağılım 16-69) 15'i kapalı, 15'i açık redüksiyonla tedavi edildi. Çıkığa en sık yol açan neden trafik kazaları (%80) idi. Kapalı redüksiyon grubunda 10 hastada posterior, ikisinde anterior, üçünde merkezi çıkık vardı; bunların sekizi izole çıkık, yedisi kırıklı çıkık idi. Açık redüksiyon grubunda 14 hastada posterior, birinde merkezi çıkık görüldü. Bunların beşinde yalnızca kalça travması, 10'unda birden fazla travma vardı. Cerrahi tedavi altı olguda ilk 24 saat içinde; dokuz olguda 5-21. günler arasında yapıldı. Posterior çıkıklar için Thompson-Epstein, femur başında kırık varsa Pipkin; merkezi çıkıklar için Judet; anterior çıkıklar için Epstein sınıflandırması kullanıldı. Sonuçlar Matta'nın klinik ölçütlerine göre değerlendirildi. Ortalama izlem süresi 49 ay (dağılım 16-84 ay) idi. Sonuçlar: Kapalı redüksiyon grubunda 11 olguda (%73.3) yeterli (çok iyi veya iyi), dört olguda (%26.7) yetersiz (orta veya kötü) sonuç elde edildi. Bu grupta tüm izole çıkıklarda ve posteriora kıtıklı çıkığı olan üç olguda sonuç yeterli idi. Açık redüksiyon grubunda dokuz olguda (%60) yeterli, altı olguda (%40) yetersiz sonuç elde edildi. Bu grupta posterior çıkıklı dokuz olguda yeterli, beşinde yetersiz sonuç alındı. Merkezi travmatik kalça çıkıklı tüm olgularda sonuç yetersiz bulundu. Kapalı redüksiyon grubunda kınklı çıkıklı bir olguda femur başı avasküler nekrozu, dört olguda dejeneratif artrit gelişti. Açık redüksiyon grubunda altı olguda dejeneratif artrit görüldü; bunların ikisinde avasküler nekroz saptandı. Çıkarımlar: Çalışmamızda, kapalı veya açık redüksiyonla tedavi edilen travmatik kalça çıkıklarında prognozu etkileyen faktörlere ışık tutucu bulgular elde edildi.

Keywords

Kalça kırıkları Kalça çıkığı Tomografi x-ışınlı bilgisayarlı Tedavi sonucu Kalça eklemi Manyetik rezonans görüntüleme Seyir Hip Fractures Hip Dislocation Tomography X-Ray Computed Treatment Outcome Hip Joint Magnetic Resonance Imaging Prognosis

🔖

Cite This Article

DURAKBAŞA, O., OKAN, N., CANBORA, K., GÖRGEÇ, M. (2005). Factors affecting the results of teratment in traumatic dislocation of the hip. Acta Orthopaedica et Traumatologica Turcica, Cilt: 39 - Sayı: 2, 133–141. https://ajindex.com/articles/354483

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (1)

Tornetta P 3rd. Hip dislocations and fractures of the femoral head. In: Bucholz RW, Heckman JD, editors. Rockwood and Green's fractures in adults. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 1547-78. 2.Gillespie WJ. The incidence and pattern of knee injury associated with dislocation of the hip. J Bone Joint Surg [Br] 1975;57:376-8. 3.Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg [Am] 1996;78:1632-45. 4.Alonso JE, Volgas DA, Giordano V, Stannard JP. A review of the treatment of hip dislocations associated with acetabular fractures. Clin Orthop Relat Res 2000;(377):32-43. 5.Hougaard K, Thomsen PB. Coxarthrosis following traumatic posterior dislocation of the hip. J Bone Joint Surg [Am] 1987;69:679-83. 6.Whitehouse GH. Radiological aspects of posterior dislocation of the hip. Clin Radiol 1978;29:431-41. 7.Hougaard K, Lindequist S, Nielsen LB. Computerised tomography after posterior dislocation of the hip. J Bone Joint Surg [Br] 1987;69:556-7. 8.Epstein HC. Traumatic dislocations of the hip. Clin Orthop Relat Res 1973;(92): 116-42. 9.Hunter GA. Posterior dislocation and fracture-dislocation of the hip. A review of fifty-seven patients. J Bone Joint Surg [Br] 1969;51:38-44. lO.Jaskulka RA, Fischer G, Fenzl G. Dislocation and fracture dislocation of the hip. J Bone Joint Surg [Br] 1991;73:465-9. ll.Dreinhofer KE, Schwarzkopf SR, Haas NP, Tscherne H. Isolated traumatic dislocation of the hip. Long-term results in 50 patients. J Bone Joint Surg [Br] 1994;76:6-12. 12.Upadhyay SS, Moulton A, Srikrishnamurthy K. An analysis of the late effects of traumatic posterior dislocation of the hip without fractures. J Bone Joint Surg [Br] 1983;65:150-2. 13.Butler JE. Pipkin Type-II fractures of the femoral head. J Bone Joint Surg [Am] 1981;63:1292-6. 14.Hougaard K, Thomsen PB. Traumatic posterior dislocation of the hip-prognostic factors influencing the incidence of avascular necrosis of the femoral head. Arch Orthop Trauma Surg 1986;106:32-5. 15.Yang RS, Tsuang YH, Hang YS, Liu TK. Traumatic dislocation of the hip. Clin Orthop Relat Res 1991;(265):218-27. 16.Sahin V, Karakas ES, Aksu S, Atlihan D, Turk CY, Halici M. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma 2003;54:520-9. 17.Epstein HC. Posterior fracture-dislocations of the hip; long-term follow-up. J Bone Joint Surg [Am] 1974;5