Section of Orthopaedics and Trauma Surgery, Ospedali Riuniti, Ancona, Italy.
Section of Orthopaedics and Trauma Surgery, Ospedali Riuniti, Ancona, Italy.
Injury. 2019 Aug;50 Suppl 4:S11-S20. doi: 10.1016/j.injury.2019.01.011. Epub 2019 Jan 17.
Traumatic hip fracture dislocation is a rare injury associated with high-energy trauma. Most of these injuries should be surgically treated. Hip dislocation is an orthopaedic emergency and reduction must be performed within 6-8 hours of trauma. We performed a retrospective analysis of 69 patients with "hip joint associated injuries", treated between January 2002 and December 2016. 33 patients were assessed at a mean follow-up of 36.9 months (range 18-132) after surgery. We propose a new classification system in which, different patterns of fracture (head and/or neck and/or acetabular) are described according to different types of hip dislocation. This anatomical-descriptive classification system is based on the concept of hip as a complex anatomical district and contains all possible traumatic injuries associated with hip dislocation. It includes isolated hip dislocation, hip dislocation with femoral head or neck fracture or hip dislocation with acetabular fracture and femoral head fracture. There are 4 groups: Each one of the previous groups is composed by different subgroups. Post-traumatic osteoarthritis is the most common complication of these hip injuries, followed by avascular necrosis of femoral head and heterotopic ossification. The bad prognosis depends on the type of trauma rather than surgical treatment.
创伤性髋关节骨折脱位是一种罕见的损伤，与高能创伤有关。大多数这些损伤都应该进行手术治疗。髋关节脱位是一种骨科急症，必须在创伤后 6-8 小时内进行复位。我们对 2002 年 1 月至 2016 年 12 月期间治疗的 69 例“髋关节相关损伤”患者进行了回顾性分析。33 例患者在手术后平均随访 36.9 个月（18-132 岁）。我们提出了一种新的分类系统，根据不同类型的髋关节脱位来描述不同类型的骨折（股骨头和/或颈和/或髋臼）。这种解剖描述分类系统基于髋关节作为一个复杂解剖区域的概念，包含了所有与髋关节脱位相关的可能创伤性损伤。它包括单纯髋关节脱位、股骨头或颈骨折伴髋关节脱位、髋臼骨折伴股骨头骨折。有 4 组：每组由不同的亚组组成。这些髋关节损伤最常见的并发症是创伤后骨关节炎，其次是股骨头缺血性坏死和异位骨化。不良预后取决于创伤类型，而不是手术治疗。
