The Treatment of Traumntic Posterior Fracture-Dislocation of the Hip

Choy, Won Sik; Lee, Kwang Won; Kim, Yoo In; Sohn, Moon Ho

Abstract

Traumatic posterior dislocation of the hip is a serious injury and must be treated as emergency. Every effort must be made to recognize the dislocation. particularly in patients with other lower extremity trauma. We perfornted computed tomography as soon as possible after closed reduction in all patients. The purpose of this study was to compare the results posterior fractvre-dislocation of the hip treated by closed reduction and closed reduction followed by an open procedure. We reviewed 27 patients out of total 29 patients with traumatic posterior dislocation of the hip between January, 1989 and October, 1993. 1. According to Thompson and Epstein classification, six patients were type 1 injury. five patients type 2 injury, five patients type 3 injury, three patients type 4 injury and eight patients type 5 injury. In the classification of fractures by the Pipkin type, there were two cases in Pipkin type 1, three cases in Pipkin type 2, one case in Pipkin type 3 and two cases in Pipkin type 4. 2. Open reduction with various internal fixation were done in twenty patients and primary bipolar endoprosthesis in two patients and total hip arthroplasty in one patient. Also. four patients were treated by closed reduction, followed by gentle traction for 6 weeks & progressive weight bearing over twelve weeks. 3. There were one case of avascular necrosis in Thompson and Epstein type 4 and two cases of posttraumatic arthritis in type 3 and 4. One case of post-traumatic arthritic patients was performed total hip arthroplasty. 4. We found that 33.3% of the cases had a exellent result by both clinical and radiological criteria, 44.4% were graded good and 11.1% were graded poor.