Treatment of Traumatic Posterior Dislocation of the Hip Joint Associated with Femoral Head Fracture

ABSTRACT

PURPOSE: This study examined the treatment of patients with posterior hip dislocation and femoral head fracture, according to the Pipkin classification, and we analyzed their clinical and radiological results. MATERIALS AND METHODS: The subjects consisted of 45 patients who were treated for posterior hip dislocation and femoral head fracture. The subjects had an average age of 39, and 38 were men and 7 were women. The average follow-up period was 33 months. The cause of injury was traffic accident in 41 cases and falling for the other four cases. According to the classification, there were 26 Type I cases, 5 Type II cases, 1 Type III case and 13 Type IV cases. The treatment methods were selected according to the patients' condition and the form of fracture. The Ebstein criteria and the Merle d'Aubigne and Postel score were used to determine whether there was a combined injury and to examine the clinical and radiological results. RESULTS: All the cases classified as Type I, II and III showed good or excellent clinical results. A primary osteosynthesis was performed on the Type III cases according to the patient's age and condition, with particularly good results. An anatomical reduction in the early stages affected the clinical results of the Type IV cases. The observed complications were posttraumatic osteoarthritis (38.4%) and avascular necrosis (15.3%). CONCLUSION: The prognosis was determined by the injury's initial severity, the time for reduction and the anatomical reduction and firm fixation of the femur and the fracture fragment of the acetabulum.