Abstract

Objective: Traumatic dislocation and fracture–dislocation of the hip are rare and severe injuries often associated with high-energy trauma. Early recognition and rapid, stable reduction are essential for successful treatment; otherwise, this type of injury is associated with poor functional outcomes and high rates of complications such as avascular necrosis. This retrospective study aims to describe and analyze long-term outcomes and survival rates after a hip dislocation. Methods: Between 2008 and 2021, all patients with traumatic hip dislocation who were treated in a Level I Trauma Center were retrospectively assessed and analyzed. During the follow-up examination, two experienced surgeons carried out a clinical follow-up examination and evaluated the available X-ray images. Anterior and posterior fracture–dislocations and femoral head fractures were classified according to Stewart and Milford’s and Pipkin’s classification system, respectively. All patients were followed up using the Harris Hip Score (HHS) and Lequesne score. Results: Forty-four (38 male and 6 female) patients with a mean age of 46.02 (±19.48) years were included. The average follow-up period was 45.69 (±45.69) months. Traffic accidents were the main cause of traumatic dislocation in this series, accounting for 75% of all cases. Associated injuries were noted in 28 cases. Twenty-three and 21 patients were treated with closed and open reduction, respectively. Isolated hip dislocations without bony involvement according to Stewart and Milford type 1 occurred in five cases. Type 3 injuries were most common, followed by type 4 injuries. This study found that the type of reduction and the trauma mechanism are not significant factors in long-term prognosis (p = 0.463). Thirteen patients had subjective excellent or good results in the HHS and Lequesne score. Late post-traumatic osteoarthritis of the hip developed in 10 patients (22.7%). Patients received a hip replacement at 20.7 months (1–102) months. Thus, after 2 years, implantation of a hip prosthesis due to post-traumatic coxarthrosis was necessary in 22.7% of all cases. The type of hip dislocation classified according to Stewart and Milford had no significant influence on the implantation of a hip prosthesis. Conclusions: Excellent or good results in HHS were obtained in patients with early, stable, and accurate reduction by closed or open methods. After 2 years, 22.7% of the patients needed a total hip replacement.

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