Avascular necrosis of the femoral head after traumatic posterior hip dislocation with and without acetabular fracture
© 2020. Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: Traumatic hip dislocation can be isolated or associated with acetabular fracture. Both injuries require emergency reduction of the dislocated hip. Avascular necrosis of the femoral head (AVN) is a potential complication that accompanies these severe injuries. Our objective is to identify the risk factors that cause AVN.
METHODS: We retrospectively analyzed 44 patients with traumatic hip dislocations (Group A) and patients with posterior fracture-dislocation of the acetabulum (Group B). The average follow-up was 5.38 years in Group A, 5.59 years in Group B. We used the Thompson-Epstein classification for hip dislocation and the Harris Hip Score (HHS) for evaluating final outcomes.
RESULTS: In Group A, we analyzed 21 patients with isolated posterior hip dislocation. We had one (4.76%) case of AVN. In Group B, we analyzed 23 patients with posterior acetabular fracture-dislocation. We had eight (34.78%) patients with AVN (p = 0.016, p < 0.05). With hip reduced 6-12 h after injury, we had AVN in one (4.34%) patient, with reduction 12-24 h, AVN was present in two (8.69%), while in hip reduction done after 24 h of injury, AVN was present in five (21.73%) patients (p = 0.030, p < 0.05).
CONCLUSION: An essential prerequisite for the prevention of AVN of the femoral head after hip dislocation is emergency hip reduction. In acetabular fracture-dislocation, emergency hip reduction, anatomical reduction of the acetabular fracture and early stable osteosynthesis are also important. Main factor affecting the development of AVN is late reduction of the hip.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
European journal of trauma and emergency surgery : official publication of the European Trauma Society - 48(2022), 1 vom: 14. Feb., Seite 613-619 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Milenkovic, Sasa [VerfasserIn] |
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| Links: |
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| Themen: |
Acetabular fracture–dislocation |
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| Anmerkungen: |
Date Completed 10.02.2022 Date Revised 10.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00068-020-01495-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315015543 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020. Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: Traumatic hip dislocation can be isolated or associated with acetabular fracture. Both injuries require emergency reduction of the dislocated hip. Avascular necrosis of the femoral head (AVN) is a potential complication that accompanies these severe injuries. Our objective is to identify the risk factors that cause AVN | ||
| 520 | |a METHODS: We retrospectively analyzed 44 patients with traumatic hip dislocations (Group A) and patients with posterior fracture-dislocation of the acetabulum (Group B). The average follow-up was 5.38 years in Group A, 5.59 years in Group B. We used the Thompson-Epstein classification for hip dislocation and the Harris Hip Score (HHS) for evaluating final outcomes | ||
| 520 | |a RESULTS: In Group A, we analyzed 21 patients with isolated posterior hip dislocation. We had one (4.76%) case of AVN. In Group B, we analyzed 23 patients with posterior acetabular fracture-dislocation. We had eight (34.78%) patients with AVN (p = 0.016, p < 0.05). With hip reduced 6-12 h after injury, we had AVN in one (4.34%) patient, with reduction 12-24 h, AVN was present in two (8.69%), while in hip reduction done after 24 h of injury, AVN was present in five (21.73%) patients (p = 0.030, p < 0.05) | ||
| 520 | |a CONCLUSION: An essential prerequisite for the prevention of AVN of the femoral head after hip dislocation is emergency hip reduction. In acetabular fracture-dislocation, emergency hip reduction, anatomical reduction of the acetabular fracture and early stable osteosynthesis are also important. Main factor affecting the development of AVN is late reduction of the hip | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acetabular fracture–dislocation | |
| 650 | 4 | |a Avascular necrosis of the femoral head | |
| 650 | 4 | |a Traumatic hip dislocation | |
| 700 | 1 | |a Mitkovic, Milan |e verfasserin |4 aut | |
| 700 | 1 | |a Mitkovic, Milorad |e verfasserin |4 aut | |
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