Early versus delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation: a comparative study

Shanxi Wang,Zhengdong Zhang,Bohua Li,Xiaojun Yu,Lei Liu,Qin Li

doi:10.1186/s12891-021-04968-1

Abstract

BackgroundFew studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the safe interval time between injury and hip reduction remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation.MethodsA total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 h after injury) and delayed group (between 6 and 12 h after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation.ResultsThe mean hospital stay and fracture healing time in the early group were significantly lower than those in the delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than that in the early group. The early group had better functional outcomes in terms of Thompson-Epstein criteria, modified Merle D’Aubigné and Postel scores and physical component scale (PCS) than the delayed group.ConclusionsFor the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient rehabilitation, and obtain a better functional outcome.

Highlights

Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the safe interval time between injury and hip reduction remains controversial
For the treatment of femoral head fractures combine with posterior hip dislocation, the early and prompt hip reduction is associated with a good result [1, 2]
It has been reported that the good results can be achieved when posterior hip dislocation reduction was reduced within 12 h or 24 h, some authors emphasize that the posterior dislocation of hip should be reduced within 6 h [7, 15,16,17]

Summary

Introduction

Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the safe interval time between injury and hip reduction remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation. For the treatment of femoral head fractures combine with posterior hip dislocation, the early and prompt hip reduction is associated with a good result [1, 2]. The purpose of this study was to compare the outcomes of early and delayed hip reduction in the surgical treatment of femoral head fracture combined with posterior hip dislocation, and to define the best timing reduction

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Conclusion