The Cause of Primary Reduction Failure in Hip Dislocation with or without Hip Fracture

Abstract

Purpose: A rapid and accurate reduction is important for hip dislocated patients to avoid various potential complications, including avascular necrosis of the femoral head. We analyzed hip dislocation cases, ones that particularly failed during the primary reduction trial. Results:The rate of first reduction failure was higher, with statistical significance, in patients aged under 50 years, male gender, and those with combined around hip fractures, including femoral head and acetabular fracture (p<0.05). In particular, the presence of impacted fracture fragment in the hip joint and large size of the impacted fracture fragment was highly related to the failure of second closed reduction trial requiring open reduction. Conversely, the method of reduction, Thompson-Epstein classification, Pipkin classification were not related to the failure of closed reduction statistically (p>0.05). Conclusion:To evaluate the patients with hip dislocation, realizing the type of dislocation, presence of accompanied fracture, location and size of fracture fragment, age, as well as gender of patients is important. If the fracture fragment is impacted in the hip joint and the size of the fragment is large, then the operative treatment is considered, rather than the repetitive trial of closed reduction by constraint.

Traumatic obturator dislocation of the hip joint: About 2 cases and review of the literature

“…We had opted in our cases for functional treatment with early rehabilitation and unloading of the limb without prior traction. Indeed, some studies have determined that no increase of the necroses number in the event of immediate gentle mobilisation without traction, but the decline in these remote analyses remains to be assessed [5] , [17] , [18] .…”