Traumatic Hip Dislocation: Lecture

Cover Page

Abstract

Traumatic hip dislocations occupy the fourth place among dislocations of various localizations and, as a rule, are the result of  exposure  to  a  high-energy  traumatic  agent.  Such  injuries  are  more  often  observed  in  young  and  middle-aged  males. The main cause of hip dislocations is road accidents. The femoral head is more often dislocated posteriorly, but anterior dislocations  are  not  casuistic  and  account  for  approximately  10%.  Hip  dislocations  are  often  combined  with  acetabular fractures,  while  their  fairly  clear  clinical  picture  in  the  presence  of  fractures  can  be  leveled.  Traumatic  hip  dislocations require urgent diagnosis and treatment. After the clinical examination of the patient, an x-ray of the pelvis and hip joints are performed. Radiographic diagnosis of hip dislocation remains relevant, but modern imaging methods allows to study the hip joint in more detail and identify concomitant injuries. The main treatment for hip dislocation is closed reduction. Early dislocation reduction and the absence of damage to the structures forming the hip joint are important for the treatment results prognosis. The further patient management tactics after the dislocation reduction is determined by the results of stress tests and the CT data. When confirming the instability and associated injuries of the hip joint anatomical structures, surgical treatment is indicated. Among the complications of hip dislocation: sciatic nerve damage, post-traumatic coxarthrosis, the femoral head avascular necrosis, heterotopic ossification. Current literature data indicates the importance of early diagnosis of dislocation-associated injuries of the hip joint and periarticular tissues. Early and comprehensive repair of all existing injuries is crucial for favorable outcomes. A number of therapeutic and diagnostic methods, primarily arthroscopy, show optimistic results, but need further study.

About the authors

P. A. Berezin

Northern State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-8777-2596

Pavel  A.  Berezin 

Arkhangelsk

medicinehead@mail.ru

Russian Federation

S. V. Bragina

Northern State Medical University

Author for correspondence.
Email: svetabragina69@mail.ru
ORCID iD: 0000-0002-0900-4572

Svetlana V. Bragina— Cand. Sci. (Med.)

Arkhangelsk

Russian Federation

A. L. Petrushin

Karpogory Central District Hospital

Email: petrushin.59@mail.ru
ORCID iD: 0000-0002-3246-7452

Alexander  L.  Petrushin —  Cand.  Sci.  (Med.)

Arkhangelsk  Region, Karpogory

Russian Federation

References

  1. Arvidsson I. The hip joint: forces needed for distraction and appearance of the vacuum phenomenon. Scand J Rehabil Med. 1990;22(3):157-161.
  2. Fairbairn K.J., Mulligan M.E., Murphey M.D., Resnik C.S. Gas bubbles in the hip joint on CT: an indication of recent dislocation. AJR Am J Roentgenol.1995;164(4):931-934. doi: 10.2214/ajr.164.4.7726051.
  3. Wagner F.V., Negrão J.R., Campos J., Ward R.S., Haghighi P., Trudell D.J. et al. Capsular ligaments of the hip: anatomic, histologic, and positional study in cadaveric specimens with MR arthrography. Radiology. 2012; 263(1):189-198. doi: 10.1148/radiol.12111320.
  4. Goulet J.A. Hip dislocations. In: Browner B.D., Jupiter J.B., Krettek C., Anderson P.A., (eds.) Skeletal trauma: basic science, management, and reconstruction. 5th ed. Philadelphia, Pa: Elsevier; 2015. p. 1565-1595.
  5. Cerezal L., Kassarjian A., Canga A. Dobado M.C., Montero J.A., Llopis E. et al. Anatomy, Biomechanics, Imaging, and Management of Ligamentum Teres Injuries. RadioGraphics. 2010;30(6):1637-1651.doi: 10.1148/rg.306105516.
  6. Darren S.A., de Phillips M., Philippon M.J., Letkemann S., Simunovic N., Ayeni O.R. Ligamentum teres injuries of the hip: a systematic review examining surgical indications, treatment options, and outcomes. Arthroscopy. 2014;30(12):1634-1641. doi: 10.1016/j.arthro.2014.06.007.
  7. Philippon M.J., Kuppersmith D.A., Wolff A.B., Briggs K.K. Arthroscopic findings following traumatic hip dislocation in 14 professional athletes. Arthroscopy. 2009;25(2):169-174. doi: 10.1016/j.arthro.2008.09.013.
  8. Kellam P., Ostrum R.F. Systematic Review and Meta-Analysis of Avascular Necrosis and Posttraumatic Arthritis After Traumatic Hip Dislocation. J Orthop Trauma. 2016;30(1):10-16. doi: 10.1097/BOT.0000000000000419.
  9. Gautier E., Ganz K., Krügel N., Gill T., Ganz R. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000;82(5):679-683. doi: 10.1302/0301-620x.82b5.10426.
  10. Ehlinger M., Moser T., Adam P., Bierry G., Gangi A., Mathelin de M. et al. Early prediction of femoral head avascular necrosis following neck fracture. Orthop Traumatol Surg Res. 2011;97(1):79-88. doi: 10.1016/j.otsr.2010.06.014.
  11. Rosenthal R.E., Coker W.L. Posterior fracturedislocation of the hip: an epidemiologic review. J Trauma. 1979;19(8):572-581. doi: 10.1097/00005373-197908000-00005.
  12. Pietrafesa C.A., Hoffman J.R. Traumatic dislocation of the hip. JAMA. 1983;249(24):3342-3346. doi: 10.1001/jama.1983.03330480048029.
  13. Meena R.K., Singh A.M., Singh C.A., Chisti S., Kumar A.G., Langshong, R. Pattern of Fractures and Dislocations in a Tertiary Hospital in North-East India. Internet J Epidemiol. 2013;11:1-5. Available from: http://ispub.com/IJE/11/1/1444.
  14. Nabian M.H., Zadegan S.A., Zanjani L.O., Mehrpour S.R. Epidemiology of Joint Dislocations and Ligamentous/Tendinous Injuries among 2,700 Patients: Five-year Trend of a Tertiary Center in Iran. Arch Bone Jt Surg. 2017;5(6):426-434. doi: 10.22038/ABJS.2017.18370.1470.
  15. Lima L.C., do Nascimento R.A., de Almeida V.M.T, Façanha Filho F.A.M. Epidemiology of traumatic hip dislocation in patients treated in Ceará, Brazil. Acta Ortop Bras. 2014;22(3):151-154. doi: 10.1590/1413-78522014220300883.
  16. Babalola R.O., Laiyemo E.A., Audu S.S., Alatishe K.A., Ijezie C.N. Traumatic Hip Dislocations in an Orthopedic Center in Lagos. Niger Med J. 2018;59(2):20-23. doi: 10.4103/nmj.NMJ_139_18.
  17. Al-Bahlool A.M., Bubshait D.A., Sadat-Ali M. Outcome of traumatic hip dislocation. Ulus Travma Acil Cerrahi Derg. 2009;15(5):463-466.
  18. Pallia C.S., Scott R.E., Chao D.J. Traumatic hip dislocation in athletes. Curr Sports Med Rep. 2002;1(6): 338-345. doi: 10.1249/00149619-200212000-00007.
  19. Chudik S., Allen A., Lopez V., Warren R.F. Hip dislocations in athletes. Sports Med Arthrosc Rev.2002;10:123-133.
  20. Chigblo P., Tidjani I.F., Lawson E., Hans-Moevi A. Traumatic hip dislocation in Cotonou. J Orthop. 2016;13(4):268-271. doi: 10.1016/j.jor.2016.06.006.
  21. Лебедев В.Ф., Виноградов В.Г., Редков С.Н., Сонголов Г.И., Галеева О.П., Дмитриева Л.А. и др. Остеонекроз головки бедренной кости после травматического вывиха, полученного в результате дорожно-транспортного происшествия. Бюллетень ВСНЦ СО РАМН. 2011;4(80):107-109.
  22. Dwyer A.J., John B., Singh S.A., Mam M.K. Complications after posterior dislocation of the hip. Int Orthop.2006;30(4):224-227. doi: 10.1007/s00264-005-0056-9.
  23. Duygulu F., Karaoglu S., Kabak S., Karahan O.I. Bilateral obturator dislocation of the hip. Arch Orthop Trauma Surg.2003;123(1):36-38. doi: 10.1007/s00402-002-0450-3.
  24. Cobar A., Cahueque M., Bregni M., Altamirano M. An unusual case of traumatic bilateral hip dislocation without fracture. J Surg Case Rep. 2017 11;2017(5):rjw180. doi: 10.1093/jscr/rjw180.
  25. Levin P. Hip dislocations. In: Browner B.D., Jupiter J.B., Levine A.M., Trafton P.G., (eds.) Skeletal Trauma. Philadelphia: W.B. Saunders; 1992. p. 1329-1367.
  26. Alonge T.O., Ogunlade S.O., Idowu O.E.. Traumatic dislocation of the hip joint-pattern and management in a tropical African population. West Afr J Med. 2002;21(4):288-290. doi: 10.4314/wajm.v21i4.28000.
  27. Dreinhöfer K.E., Schwarzkopf S.R., Haas N.P., Tscherne H. Isolated traumatic dislocation of the hip. Long-term results in 50 patients. J Bone Joint Surg Br.1994;76(1):6-12. doi: https://doi.org/10.1302/0301-620x.76B1.8300683.
  28. Calisir C., Fishman E.K., Carrino J.A., Fayad L.M. Fracture-dislocation of the hip: what does volumetric computed tomography add to detection,characterization, and planning treatment? J Comput Assist Tomogr. 2010;34(4):615-620. doi: 10.1097/RCT.0b013e3181d344fb.
  29. Clegg T.E., Roberts C.S., Greene J.W., Prather B.A. Hip dislocations: epidemiology, treatment, and outcomes. Injury. 2010;41(4):329-334. doi: 10.1016/j.injury.2009.08.007.
  30. Hak D.J, Goulet J.A. Severity of injuries associated with traumatic hip dislocation as a result of motor vehicle collisions. J Trauma. 1999;47(1):60-63. doi: 10.1097/00005373-199907000-00014.
  31. Cooper J., Tilan J., Rounds A.D., Rosario S., Inaba K., Marecek G.S. Hip dislocations and concurrent injuries in motor vehicle collisions. Injury. 2018;49(7):1297-1301. doi: 10.1016/j.injury.2018.04.023.
  32. Funsten R.V, Kinser P., Frankel C.J. Dashboard dislocations of the hip: A report of twenty cases of traumatic dislocation. J Bone Joint Surg.1938;20:124-132.
  33. Monma H., Sugita T. Is the mechanism of traumatic posterior dislocation of the hip a brake pedal injury rather than a dashboard injury? Injury. 2001;32(3):221-222. doi: 10.1016/s0020-1383(00)00183-2.
  34. Буачидзе О.Ш., Оноприенко Г.А., Волошин В.П., Зубиков В.С. Хирургия тазобедренного сустава. Москва: Медицина; 2002. с. 20-26.
  35. Henle P., Kloen P., Siebenrock K.A. Femoral head injuries: Which treatment strategy can be recommended? Injury. 2007;38(4):478-488. doi: 10.1016/j.injury.2007.01.023.
  36. Admani A., Gakuya E. Anterior superior dislocation of the hip joint: A report of 3 cases and review of the literature. East Afr Orthop J.2014;8(2):71-75.
  37. Upadhyay S.S., Moulton A., Burwell R.G. Biological factors predisposing to traumatic posterior dislocation of the hip. A selection process in the mechanism of injury. J Bone Joint Surg Br.1985;67:232-236.
  38. Berkes M.B., Cross M.B., Shindle M.K., Bedi A., Kelly B.T. Traumatic posterior hip instability and femoroacetabular impingement in athletes.Am J Orthop (Belle Mead NJ). 2012;41(4):166-171.
  39. Steppacher S.D., Albers C.E., Siebenrock K.A., Tannast M., Ganz R. Femoroacetabular impingement predisposes to traumatic posterior hip dislocation. Clin Orthop Relat Res. 2013;471(6):1937-1943. doi: 10.1007/s11999-013-2863-4.
  40. Thompson V.P., Epstein H.C. Traumatic dislocation of the hip; a survey of two hundred and four cases covering a period of twenty-one years. J Bone Joint Surg Am. 1951;33-A (3):746-778.
  41. Stewart M.J, Milford L.W. Fracture-dislocation of the hip; an end-result study. J Bone Joint Surg Am. 1954;36(A:2):315-342.
  42. Epstein H.C, Wiss D.A. Traumatic anterior dislocation of the hip. Orthopedics. 1985;8(1):130, 132-134.
  43. Moreta J., Foruria x., Sánchez A., Aguirre U. Prognostic Factors After a Traumatic Hip Dislocation. A LongTerm Retrospective Study. Rev Esp Cir Ortop Traumatol. 2017;61(6):367-374. doi: 10.1016/j.recot.2017.07.007.
  44. Goddard N.J. Classification of traumatic hip dislocation. Clin Orthop Relat Res. 2000;(377):11-14. doi: 10.1097/00003086-200008000-00004.
  45. Гиршин С.Г., Лазишвили Г.Д., Дубров В.Э. Вывихи и переломо-вывихи бедра в Повреждения и заболевания мышц, сухожилий и связок. Москва: ООО «Авторская книга»; 2013. c. 181-187.
  46. Brooks R.A., Ribbans W.J. Diagnosis and imaging studies of traumatic hip dislocations in the adult. Clin Orthop Relat Res. 2000;(377):15-23. doi: 10.1097/00003086-200008000-00005.
  47. Rickman M., Buchler L. Traumatic hip dislocations. In: Buchler L., Keel M.J.B., (eds.) Fractures of the Hip. Switzerland, Pa: Springer; 2019. р. 95-103.
  48. Mandell J.C., Marshall R.A., Weaver M.J., Harris M.B., Sodickson A.D., Khurana B. Traumatic Hip Dislocation: What the Orthopedic Surgeon Wants to Know. Radiographics. 2017;37(7):2181-2201. doi: 10.1148/rg.2017170012.
  49. Borrelli J. Jr., Ricci W.M., Steger-May K., Totty W.G., Goldfarb C. Postoperative Radiographic Assessment of Acetabular Fractures: A Comparison of Plain Radiographs and CT Scans. J Orthop Trauma. 2005;19(5):299-304.
  50. Gakuu L.N. An unstable fracture dislocation of the hip due to an occult free intra-articular fragment: case report. East Afr Med J.1996;73(9):625-626.
  51. Baird R.A., Schobert W.E., Pais M.J., Ahmed M., Wilson W.J., Farjalla G.L. et al. Radiographic identification of loose bodies in the traumatized hip joint. Radiology. 1982;145(3):661-665. doi: 10.1148/radiology.145.3.7146393.
  52. Ebraheim N.A., Savolaine E.R., Skie M.C., Hoeflinger M.J. Soft-tissue window to enhance visualization of entrapped osteocartilaginous fragments in the hip joint. Orthop Rev. 1993;22(9):1017-1021.
  53. Laorr A., Greenspan A., Anderson M.W., Moehring H.D., McKinley T. Traumatic hip dislocation: early MRI findings. Skeletal Radiol. 1995;24(4):239-245. doi: 10.1007/BF00198406.
  54. Mandell J.C., Marshall R.A., Banffy M.B., Khurana B., Weaver M.J. Arthroscopy After Traumatic Hip Dislocation: A Systematic Review of Intra-articular Findings, Correlation With Magnetic Resonance Imaging and Computed Tomography, Treatments, and Outcomes. Arthroscopy. 2018;34(3):917-927. doi: 10.1016/j.arthro.2017.08.295.
  55. Potter H.G., Montgomery K.D., Heise C.W., Helfet D.L. MR imaging of acetabular fractures: value in detecting femoral head injury, intraarticular fragments, and sciatic nerve injury. AJR Am J Roentgenol. 1994;163(4):881886. doi: 10.2214/ajr.163.4.8092028.
  56. Waddell B.S., Mohamed S., Glomset J.T., Meyer M.S. A detailed review of hip reduction maneuvers: a focus on physician safety and introduction of the Waddell technique. Orthop Rev (Pavia). 2016 21;8(1):6253. doi: 10.4081/or.2016.6253.
  57. Allis O.H. The Hip. Philadelphia, PA: Dorman Printer; 1895. р.14-26.
  58. Stimson L.A. Five cases of dislocation of the hip. NY Med J.1889;50:118-121.
  59. Джанелидзе Ю.Ю. Вывихи тазобедренного сустава и их вправление при положении больного на животе. Собр. соч. : в 5 т. Москва: Изд-во АМН СССР; 1953. Т. 5. с. 9-20.
  60. Poelsky P.E., Poelsky F.A. Intrapelvic dislocation of the femoral head following anterior dislocation of the hip: a case re report. J Bone Joint Surg Am.1972;54(5):1097-1098.
  61. Toms A.D., Williams S., White S.H. Obturator dislocation of the hip. J Bone Joint Surg Br. 2001;83(1):113-115. doi: 10.1302/0301-620x.83b1.10289.
  62. Ahmed G., Shiraz S., Riaz M., Ibrahim T. Late versus early reduction in traumatic hip dislocations: a meta-analysis. Eur J Orthop Surg Traumatol. 2017;27(8):1109-1116. doi: 10.1007/s00590-017-1988-7.
  63. Beebe M.J., Bauer J.M., Mir H.R. Treatment of Hip Dislocations and Associated Injuries: Current State of Care. Orthop Clin North Am. 2016;47(3):527-49. doi: 10.1016/j.ocl.2016.02.002.
  64. Bommiasamy A.K., Opel D., McCallum R., yonge J.D., Perl V.U., Connelly C.R. et al. Conscious sedation versus rapid sequence intubation for the reduction of native traumatic hip dislocation. Am J Surg. 2018;216(5):869-873. doi: 10.1016/j.amjsurg.2018.02.023.
  65. Foulk D.M., Mullis B.H. Hip dislocation: evaluation and management. J Am Acad Orthop Surg. 2010;18(4):199-209. doi: 10.5435/00124635-201004000-00003.
  66. Tornetta P.3rd, Mostafavi H. Hip Dislocation: Current Treatment Regimens. J Am Acad Orthop Surg.1997;5(1):27-36. doi: 10.5435/00124635-199701000-00004.
  67. Uzel A-P., Bertino R., Daculsi G., Laflamme G.y. Irreducible traumatic posterior hip dislocation with entrapment and a buttonhole effect. Chin J Traumatol.2011;14(6):367-370.
  68. Karthik K., Sundararajan S.R., Dheenadhayalan J., Rajasekaran S. Incongruent Reduction Following Post-Traumatic Hip Dislocations as an Indicator of Intra-Articular Loose Bodies: A Prospective Study of 117 Dislocations. Indian J Orthop. 2011;45(1):33-38. doi: 10.4103/0019-5413.73650.
  69. Bastian J.D., Turina M., Siebenrock K.A., Keel M.J.B. Long-term outcome after traumatic anterior dislocation of the hip. Arch Orthop Trauma Surg.2011;131(9):1273-1278. doi: 10.1007/s00402-011-1299-0.
  70. Yaari L.S., Kadar A., Shemesh S., Haviv B., Leslie M.P. Medium-term outcome and classification of traumatic anterior hip dislocations. Hip Int. 2020 May 29. doi: 10.1177/1120700020918868. Online ahead of print.
  71. De Lee J.C., Evans J.A., Thomas J. Anterior dislocation of the hip and associated femoral-head fractures. J Bone Joint Surg Am.1980;62(6):960-964.
  72. Newman J.T., Saroki A.J., Philippon M.J. Hip arthroscopy for the management of trauma: a literature review. J Hip Preserv Surg.2015;2(3):242-248. doi: 10.1093/jhps/hnv047.
  73. Ross J.R., Larson C.M, Bedi A. Indications for Hip Arthroscopy. Sports Health. 2017;9(5):402-413. doi: 10.1177/1941738117712675.
  74. Ilizaliturri V.M. Jr, Gonzalez-Gutierrez B., GonzalezUgalde H., Camacho-Galindo J. Hip arthroscopy after traumatic hip dislocation. Am J Sports Med. 2011;39 Suppl:50S-57S. doi: 10.1177/0363546511411642.
  75. Cornwall R., Radomisli T.E. Nerve injury in traumatic dislocation of the hip. Clin Orthop Relat Res. 2000;(377):84-91. doi: 10.1097/00003086-200008000-00012.
  76. Epstein H.C. Traumatic dislocations of the hip. Clin Orthop Relat Res. 1973;(92):116-142. doi: 10.1097/00003086-197305000-00011.
  77. Hillyard R.F., Fox J. Sciatic nerve injuries associated with traumatic posterior hip dislocations. Am J Emerg Med.2003;21(7):545-548. doi: 10.1016/j.ajem.2003.08.014.
  78. Hoffman A., Taylor B.C. Asymmetric Bilateral Hip Dislocations with a Pulseless Left Lower Extremity: A Case Report. JBJS Case Connect. 2019;9(4):e0479. doi: 10.2106/JBJS.CC.18.00479.
  79. Amendola L., Orlandi P.E., Tigani D. Neglected pulmonary thromboembolism in a traumatic anterior hip dislocation: A case report. J Clin Orthop Trauma. 2019;10(Suppl 1):S197-S200. doi: 10.1016/j.jcot.2019.02.005.
  80. Lieberman, J.R., Altchek, D.W., Salvati, E.A. Recurrent dislocation of a hip with a labral lesion: treatment with a modified Bankart-type repair. Case report. J Bone Joint Surg Am. 1993;75(10):1524-1527. doi: 10.2106/00004623-199310000-00013.
  81. Leclerc J-T., Belzile E.L. Recurrent Posterior Hip Dislocations on a Cam-Type Femoroacetabular Impingement: A Case Report. Orthop J Sports Med. 2018;6(7):2325967118783671. doi: 10.1177/2325967118783671.
  82. Carlson B.C., Desy N.M., Johnson J.D., Trousdale T.R., Leunig M. Ganz R. et al. Modern Surgical Treatment of Recurrent Posterior Dislocation of the Native Hip. J Bone Joint Surg Am. 2018;100(12):1056-1063. doi: 10.2106/JBJS.17.01170.
  83. Hougaard K., Thomsen P.B. Traumatic posterior dislocation of the hip: prognostic factors influencing the incidence of avascular necrosis of the femoral head. Arch Orthop Trauma Surg. 1986;106(1):32-35. doi: 10.1007/BF00435649.
  84. Mitsionis G.I., Lykissas M.G., Motsis E., Mitsiou D., Gkiatas I., xenakis T.A. et al. Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture: a study with a minimum followup of 15 years. J Orthop Trauma. 2012;26(8):460-465. doi: 10.1097/BOT.0b013e31822c4d6c.
  85. Sahin V., Karakaş E.S., Aksu S., Atlihan D., Turk C.y., Halici M. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma. 2003;54(3):520-529. doi: 10.1097/01.TA.0000020394.32496.52.

Statistics

Views

Abstract: 232

Dimensions

Article Metrics

Metrics Loading ...

PlumX


Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies