Abstract
BackgroundThe purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction.MethodsThirteen patients admitted between January 2010 to February 2018 with a mean duration from injury to surgery of 5.0 ± 2.1 months and an average preoperative leg-length discrepancy of 7.7 ± 2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb length discrepancy were evaluated.ResultsAll patients had posterior dislocations, and nine patients presented with acetabular fractures and were followed-up for at least 12 months. The average traction duration of external fixators was 28.8 ± 8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb length discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in three patients.ConclusionEffective correction of limb length discrepancy and improved function were observed in patients with neglected hip dislocations and limb equality using traction by external fixation combined with second-stage open reduction. Further follow-up is required to determine long-term outcomes.
Highlights
The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction
Recognition and a prompt reduction is of great importance [3, 4] because delayed diagnosis may lead to long-term complications including avascular necrosis of the femoral head (AVN) and osteoarthritis [5]
The common treatments reported in previous studies for neglected hip dislocation included skeletal traction and open reduction
Summary
The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction. In developing countries, patients may not seek medical attention or visit the Common clinical manifestations of neglected hip dislocation are shortening of the limb and limited function of the hip joint. The common treatments reported in previous studies for neglected hip dislocation included skeletal traction and open reduction. These treatments are associated with unsatisfactory outcomes and a high incidence of post-operative complications such as nerve injury, AVN, and osteoarthritis [8, 9]. Garrett et al recommended total hip replacement (THR) for hip dislocations with a duration of > 3 months [10], but others have reported that limited correction of limb length
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