Outcomes of treatment for femoral head fractures with hip dislocation

Senthil, S (2016) Outcomes of treatment for femoral head fractures with hip dislocation. Masters thesis, Madras Medical College, Chennai.


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BACK GROUND: Femoral head fractures following posterior dislocation of hip are relatively uncommon, reported incidence ranged from 4% to 17% in different studies. These are seen in polytraumatized patients, especially after motor vehicle accidents. The common complications include avascular necrosis, arthritis and heterotropic ossification. AIM OF THE STUDY: To assess the clinical and functional outcome of treatment for femoral head fractures in thirteen patients managed in our Institute of Orthopaedics and Traumatology, Madras Medical College and Rajiv Gandhi Government General Hospital over a period of 5 years from July 2010 to July 2015 retrospectively and prospectively. MATERIALS AND METHODS: We reviewed thirteen patients who were admitted to our emergency department for femoral head fracture with posterior hip dislocation between July 2010 to September 2015. There were 13 patients of which 11 were males (84.61%) and 2 were females (15.38%). They were in the age group of 19-53 years with the mean age of 36 years; seven patients (53.84%) had additional injuries. Closed reduction done in twelve patients at the time of presentation, one patient presented late with neglected pipkin type IV and the attempt unsuccessful. Treatment options included conservative in one case(pipkin type I), excision of fragment in one case(pipkin type I), open reduction and internal fixation with Herbert screws using Ganz safe surgical dislocation in 8 cases(4 pipkin type I, 3 pipkin type II, 1 pipkin type III) and total hip replacement in three cases(pipkin type II, type III and type IV). RESULTS: The average age of the patients at the time of the presentation was 36 years (range:19-53 years). There were 11 male and 2 female patients(male:female=5.5:1). Follow-up ranged from 7 to 60 months with an average of 30.08 months. Except for two cases, outcome by the Merle d’Aubigne and Postel score and the HHS was found equal. Eleven out of 13 patients (83.3%) showed good or excellent results in both scores. Two patients had fair outcome as these patient had other associated injuries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Posrerior hip dislocation, femur head fracture, Ganz surgical dislocation.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 13:51
Last Modified: 16 Sep 2017 13:51
URI: http://repository-tnmgrmu.ac.in/id/eprint/3187

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