Traumatic hip fracture-dislocation: A middle-term follow up study and a proposal of new classification system of hip joint associated injury

Pascarella, R; Fantasia, Rossana; Sangiovanni, P.; Maresca, A; Massetti, Daniele; Politano, Rocco; Cerbasi, Simone

doi:10.1016/j.injury.2019.01.011

Cited by 24 publications

(26 citation statements)

References 20 publications

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“…Furthermore, in our Cox regression models, dislocation of the hip joint was the sole independent risk factor for poor outcomes. Although some recent studies have shown that early reduction of the dislocated hip joint was not found to have as favorable an impact in terms of avascular necrosis [1,13,14], it is generally accepted that the rapid reduction of a hip dislocation is important to reduce the likelihood of avascular necrosis [3]. This case series indicated that delayed reduction might be a potential cause of poor outcomes.…”

Section: Discussionmentioning

confidence: 78%

“…The treatment principle for intertrochanteric fracture combined with an acetabular fracture is similar to an isolated intertrochanteric fracture. Intertrochanteric fractures are generally considered unstable [3,8]; thus, surgical treatment has been performed in all patients. If a patient received surgical treatment for an acetabular fracture, the intertrochanteric fracture could be treated by the same incision (or with some extension).…”

Section: Discussionmentioning

confidence: 99%

“…The general information, etiology, and fracture classi cations of patients were identi ed based on either radiological images or medical records. The Evans' classi cation system and Letournel classi cation system [3] were used to evaluate intertrochanteric fracture and acetabular fracture, respectively. This study was approved by the Institutional Review Board of the Third Hospital of Hebei Medical University and was conducted in accordance with the Declaration of Helsinki.…”

Section: Study Populationmentioning

confidence: 99%

“…In some cases, an acetabular fracture may coincide with a fracture of the proximal femur (and together with a dislocation of the hip joint). A so-called dashboard injury [3] includes a fractured posterior wall of the acetabulum with or without anatomical insult to the proximal femur. Based on the anatomy site of a proximal femoral fracture, these fractures could be divided into three subgroups: fractures involving the acetabulum and femoral head, femoral neck and femoral trochanter.…”

Section: Introductionmentioning

confidence: 99%

“…The rst two kinds of fractures might be more common because there have been some reports about them [4][5][6][7][8]. Several reports [3,7] about intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum have been found. Additionally, ipsilateral fracture of the femoral neck associated with fracture of the acetabulum is also frequently reported [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

Liu

et al. 2020

Preprint

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Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.

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