Late versus early reduction in traumatic hip dislocations: a meta-analysis

Ahmed, Ghalib; Shiraz, Salman; Riaz, Muhammad; Ibrahim, Talal

doi:10.1007/s00590-017-1988-7

Cited by 35 publications

(27 citation statements)

References 20 publications

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“…While lots of evidences suggested that the time to hip reduction in a femoral fracture-dislocation is critical, the safe interval time between injury and reduction still remains controversial [10,23]. Early research suggested that the posterior hip dislocation should be reduced within 24 hours, otherwise the prognosis will be poor [14].…”

Section: Discussionmentioning

confidence: 99%

“…Early research suggested that the posterior hip dislocation should be reduced within 24 hours, otherwise the prognosis will be poor [14]. However, more and more studies reported that reduced within 6 hours help to minimize the incidence of complications and achieve a good result [15,23]. There is also evidence that good results were achieved when reduction was performed within 12 hours [13].…”

Section: Discussionmentioning

confidence: 99%

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Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

Wang¹,

Li²,

Zhang³

et al. 2021

Preprint

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Background: Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the the safe interval time between injury and reduction still remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in treating femoral head fracture combined with posterior hip dislocation. Methods: A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 hours after injury) and delayed group (between 6 - 12 hours after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation.Results: The mean hospital day and fracture healing time in the early group were significantly lower than delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than early group. The early group had better functional outcomes in term of Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores and physical component scale (PCS) than delayed group. Conclusions: For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient recovery as well as obtain better functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

Wang¹,

Li²,

Zhang³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In a longitudinal study, Mehlman et al found a 20-fold increase in AVN of the femoral head for pediatric patients having reduction performed after six hours, while 95% of patients who underwent reduction in less than six hours had favorable outcomes 3. Additionally, a meta-analysis comparing AVN rates for early (< 6 hours) and late reductions (> 6 hours) from five eligible studies showed a significant, decreased risk of AVN to those undergoing early reduction 9. Other potential complications of pediatric hip dislocation include sciatic nerve injury, coxa magna (a usually asymptomatic rounding and shortening of the femoral head and neck), re-dislocation, and post-injury arthritis.…”

Section: Discussionmentioning

confidence: 99%

Emergency Physician Reduction of Pediatric Hip Dislocation

Capehart

Balcik

Sikora

et al. 2019

Clinical Practice and Cases in Emergency Medicine

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Traumatic hip dislocation in children is relatively rare but presents a true emergency, as a delay in reduction can result in avascular necrosis of the femoral head and long-term morbidity. After sustaining a traumatic posterolateral hip dislocation, a seven-year-old boy presented to an outside facility where no attempt was made at reduction. The patient was transferred to our emergency department (ED) where he was promptly sedated and the dislocation was reduced in a timely manner. Emergency physicians have demonstrated high success rates with dislocation reduction. ED reduction should occur immediately to reduce the likelihood of long-term complications. While timely consultation with a pediatric orthopedist is recommended, that should not delay reduction. The reduction should ideally be performed before the patient leaves the department or is transferred to another facility.

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“…Одним из ключевых моментов являются сроки устранения дислокации. По данным ряда авторов, при позднем вправлении вывиха возрастает частота возникновения АНГБК [62,63]. Некоторые исследователи при отсутствии тяжелых сочетанных повреждений рекомендуют осуществлять репозицию в условиях отделения неотложной помощи (приемного отделения) [63].…”

Section: клиника и диагностикаunclassified

Traumatic Hip Dislocation: Lecture

Berezin

Bragina

Petrushin

2021

Traumatology and Orthopedics of Russia

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Traumatic hip dislocations occupy the fourth place among dislocations of various localizations and, as a rule, are the result of exposure to a high-energy traumatic agent. Such injuries are more often observed in young and middle-aged males. The main cause of hip dislocations is road accidents. The femoral head is more often dislocated posteriorly, but anterior dislocations are not casuistic and account for approximately 10%. Hip dislocations are often combined with acetabular fractures, while their fairly clear clinical picture in the presence of fractures can be leveled. Traumatic hip dislocations require urgent diagnosis and treatment. After the clinical examination of the patient, an x-ray of the pelvis and hip joints are performed. Radiographic diagnosis of hip dislocation remains relevant, but modern imaging methods allows to study the hip joint in more detail and identify concomitant injuries. The main treatment for hip dislocation is closed reduction. Early dislocation reduction and the absence of damage to the structures forming the hip joint are important for the treatment results prognosis. The further patient management tactics after the dislocation reduction is determined by the results of stress tests and the CT data. When confirming the instability and associated injuries of the hip joint anatomical structures, surgical treatment is indicated. Among the complications of hip dislocation: sciatic nerve damage, post-traumatic coxarthrosis, the femoral head avascular necrosis, heterotopic ossification. Current literature data indicates the importance of early diagnosis of dislocation-associated injuries of the hip joint and periarticular tissues. Early and comprehensive repair of all existing injuries is crucial for favorable outcomes. A number of therapeutic and diagnostic methods, primarily arthroscopy, show optimistic results, but need further study.

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Late versus early reduction in traumatic hip dislocations: a meta-analysis

Abstract: III.

Cited by 35 publications

References 20 publications

Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

Emergency Physician Reduction of Pediatric Hip Dislocation

Traumatic Hip Dislocation: Lecture

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