A Clinical Study of Traumatic Posterior Fracture-Dislocation of the Hip: 13 cases with operative treatment

Kim, Won Yoo; Kim, Jin Young; Park, Kun Young; Jeong, Chang Boon

Abstract

Traumatic Posterior hip fracture-dislocation is uncommon injury, which induces the traumatic arthritis, joint contracture and avascular necrosis of the femoral head as a late complication. Among 23 patients with traumatic fracture-dislocation of the hips, 13 patients who underwent operative intervention were reviewed retrospectively: all patients were men ranging from 24 to 59 years old. A dash-board injury of car accident was leading cause of the traumatic dislocation in this series(9 cases, 64%). Associated injuries were found in 11 cases(84%). In follow-up ranging from 12 months to 36 months(averge, 18 months). Ten were treated by closed reduction; 6, by closed reduction followed by subsequent open reduction and internal fixation for unstable fracture of the acetabulum; 3, by primary open reduction; and 4, delayed open reduction. The results according to the Epstein and Thompson clinical criteria for evaluating results were good at 5 of 6 patients treated by closed reduction followed by open reduction for acetabular fracture. It was concluded that early closed reduction followed by open anatomic reduction with removal of all loose fragments of bone and cartilage and restoration of stability by internal fixation of the fracture of the acetaulum offers the best prognosis.