Surgical dislocation of the hip for the fixation of acetabular fractures

Tannast, M; Krüger, A; Mack, PW; Powell, JN; Hosalkar, HS; Siebenrock, KA (2010). Surgical dislocation of the hip for the fixation of acetabular fractures. Journal of bone and joint surgery - British volume, 92(6), pp. 842-52. London: British Editorial Society of Bone and Joint Surgery 10.1302/0301-620X.92B6.22994

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Surgical dislocation of the hip in the treatment of acetabular fractures allows the femoral head to be safely displaced from the acetabulum. This permits full intra-articular acetabular and femoral inspection for the evaluation and potential treatment of cartilage lesions of the labrum and femoral head, reduction of the fracture under direct vision and avoidance of intra-articular penetration with hardware. We report 60 patients with selected types of acetabular fracture who were treated using this approach. Six were lost to follow-up and the remaining 54 were available for clinical and radiological review at a mean follow-up of 4.4 years (2 to 9). Substantial damage to the intra-articular cartilage was found in the anteromedial portion of the femoral head and the posterosuperior aspect of the acetabulum. Labral lesions were predominantly seen in the posterior acetabular area. Anatomical reduction was achieved in 50 hips (93%) which was considerably higher than that seen in previous reports. There were no cases of avascular necrosis. Four patients subsequently required total hip replacement. Good or excellent results were achieved in 44 hips (81.5%). The cumulative eight-year survivorship was 89.0% (95% confidence interval 84.5 to 94.1). Significant predictors of poor outcome were involvement of the acetabular dome and lesions of the femoral cartilage greater than grade 2. The functional mid-term results were better than those of previous reports. Surgical dislocation of the hip allows accurate reduction and a predictable mid-term outcome in the management of these difficult injuries without the risk of the development of avascular necrosis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Tannast, Moritz; Krüger, Andreas and Siebenrock, Klaus-Arno

ISSN:

0301-620X

Publisher:

British Editorial Society of Bone and Joint Surgery

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:08

Last Modified:

04 May 2014 23:04

Publisher DOI:

10.1302/0301-620X.92B6.22994

PubMed ID:

20513883

Web of Science ID:

000279112300017

URI:

https://boris.unibe.ch/id/eprint/724 (FactScience: 200585)

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