Management of Traumatic Posterior Dislocation of Hip with Fracture Head of Femur

Traumatic dislocation of hip is a rare injury that occurs due to high energy trauma. Fracture head of femur associated with dislocation of hip occurs is even rarer. Some surgeons recommend conservative treatment, while others recommend surgery. The purpose of this study was to evaluate the method of treatment and outcomes of femoral head fractures. Methods: This study was conducted between 2006-2018 & included 4 patients who presented to the department and were diagnosed with posterior dislocation of hip with fracture of head of femur with a minimum followup of 12 months. Results: All the four cases that presented to the hospital were managed by closed reduction of the hip on the same day & were managed surgically the very next day. Three of four patients presented with clinically & radiologically excellent results on followup. Conclusion: Traumatic dislocation of hip with fractures of the femoral head are rare. Patients can be surgically managed by either excision of fragments or fixation using headless screws. Avascular necrosis and post traumatic degenerative disease of the hip occur but are relatively uncommon

Platelet-rich plasma combined with surgical hip joint dislocation:An effective option for femoral head necrosis in the peri-collapse stage / 医学研究生学报

Objective Reports are rarely seen about the application of platelet-rich plasma (PRP) combined with surgical dislocation of head and neck fenestration (HNF) in the treatment of osteonecrosis of the femoral head (ONFH) in the peri-collapse stage. The purpose of this study was to investigate the clinical effects of PRP combined with surgical dislocation of HNF in the treatment of ONFH. Methods Using PRP combined with surgical dislocation of HNF,we treated 18 ONFH patients with 22 hips involved,in-cluding 7 cases of ARCO stage Ⅱc,10 cases of stage Ⅲa,and 5 cases of stage Ⅲb, and followed them up for 12.40±3.12 months. We evaluated the clinical results and compared the Harris scores and radiographic manifestations obtained before and after surgery. Results The overall Harris scores of the patients at 12 months after surgery were significantly higher than the baseline(86.84±6.44 vs 73.73±5.42,P=0.04),(87.73±2.43 vs 74.23±7.30,P<0.05) in the stageⅡc group,(85.22±7.63 vs 72.82±5.31,P<0.05) in the stageⅢa group,and(78.86±5.91 vs 69.37±6.13,P<0.05) in the stageⅢb group. The rate of excellence was 90.91% and that of im-provement was 95.45%.There were no such postoperative complications as nonunion,infection,or osteothrombosis. Conclusion PRP com-bined with surgical dislocation of HNF exhibited an excellent short-term effect in the treatment of ONFH in the peri-collapse stage, which has provided a new option for the management of the disease.

Treatment of Femoroacetabular Impingement with Surgical Dislocation

BACKGROUND: The authors report the results of femoroacetabular impingement (FAI) treated with a surgical dislocation. METHODS: From April 2005 to May 2007, 15 FAI hips were treated with a surgical dislocation. The male/female ratio, mean age and mean symptom duration was 12/2, 35.8 years and 2.3 years, respectively. Radiographs and MR arthrograms were taken. The clinical evaluation involved changes in the pre- and postoperative Harris hip score (HHS). RESULTS: There were 12 hips (80%) with at least one structural abnormality in the radiographs, with 11 (79%) labral tears and 8 (73%) abnormally high angles in the MR arthrograms. We performed 15 osteochondroplasties, 12 labral repairs, 12 acetabuloplasty, and 3 debridements. The mean HHS improved from 76 to 93 points. Three non-unions of the trochanteric osteotomy sites were encountered as complications. CONCLUSIONS: Radiographs and MR arthrograms are important for making a proper diagnosis of FAI and planning treatment. A surgical dislocation can be used to treat FAI but further technical improvements will be needed for fixation of the greater trochanteric osteotomy sites.