Affiliated with University of Minnesota - Regions Hospital, Saint Paul, MN, USA.
Affiliated with Harborview Medical Center, Seattle, WA, USA.
Injury. 2021 Aug;52(8):2327-2332. doi: 10.1016/j.injury.2021.03.007. Epub 2021 Mar 5.
Anterior native hip dislocation remains poorly studied due to the rarity of the injury. The aim of this study was to describe injury characteristics of anterior hip dislocation, detail its initial treatment, and determine the intermediate term outcomes including the rate of conversion to total hip arthroplasty (THA).
A cross-sectional study was performed at a single urban academic Level 1 trauma center for patients who sustained traumatic anterior hip dislocations from 2010-2017. Baseline demographic, injury, and treatment data were recorded. Patients were contacted to inquire about subsequent surgery and complete functional outcome questionnaires. Available post-operative radiographs were also reviewed.
Thirty-two anterior hip dislocations met inclusion criteria and were included in the study. 69% of dislocations were obturator dislocations and 31% iliac dislocations. Only 22% were simple dislocations with the remainder having an associated femoral head fracture and/or acetabular fracture. Iliac dislocations were more likely to be associated with acetabular fractures and require surgical treatment while obturator dislocations were more likely to be simple dislocations or have femoral head fractures. Excluding two patients treated with acute THA at the time of injury, follow-up information was available for 16 patients at a minimum of eighteen months from the time of injury. Only one required subsequent conversion to THA. For the remaining fifteen patients, modified Harris hip scores (mHHS) averaged 82.6, PROMIS global physical health averaged 51.9, and PROMIS global mental health averaged 48.3 with mean follow-up of 4.2 years. mHHS was significantly higher for obturator dislocations and a negative association was seen with age.
Obturator dislocations occurred twice as frequently as iliac dislocations. Associated acetabular or femoral head fractures are common. Conversion to THA was low, occurring in only 1 of 16 patients not treated with acute arthroplasty. Obturator dislocations and age less than 45 years old at the time of injury were associated with better functional outcome at intermediate term follow-up.
由于损伤罕见，前向原发性髋关节脱位的研究仍不完善。本研究旨在描述髋关节前脱位的损伤特征，详细描述其初始治疗，并确定中期结果，包括全髋关节置换术（THA）的转换率。
对 2010 年至 2017 年期间在一家市级学术性 1 级创伤中心发生创伤性前向髋关节脱位的患者进行了一项横断面研究。记录了基线人口统计学、损伤和治疗数据。联系患者询问后续手术和完整的功能结果问卷。还回顾了可获得的术后 X 光片。
32 例前向髋关节脱位符合纳入标准并纳入研究。69%的脱位为闭孔脱位，31%为髂骨脱位。只有 22%为单纯脱位，其余均伴有股骨头骨折和/或髋臼骨折。髂骨脱位更可能与髋臼骨折相关，需要手术治疗，而闭孔脱位更可能为单纯脱位或股骨头骨折。除 2 例在受伤时行急性 THA 治疗的患者外，16 例患者在受伤后至少 18 个月获得了随访信息。仅 1 例需要后续转换为 THA。对于其余 15 名患者，改良 Harris 髋关节评分（mHHS）平均为 82.6，PROMIS 全球身体健康平均为 51.9，PROMIS 全球心理健康平均为 48.3，平均随访时间为 4.2 年。mHHS 在闭孔脱位中更高，与年龄呈负相关。
闭孔脱位的发生率是髂骨脱位的两倍。常见髋臼或股骨头骨折。只有 16 例未接受急性关节置换术的患者中，有 1 例转换为 THA。受伤时年龄小于 45 岁和闭孔脱位与中期随访时更好的功能结果相关。
