Patients undergoing surgical hip dislocation for the treatment of acetabular fractures show favourable long-term outcome

2017 ◽  
Vol 99-B (4) ◽  
pp. 508-515 ◽  
Author(s):  
P. C. Haefeli ◽  
G. S. Marecek ◽  
M. J. B. Keel ◽  
K. A. Siebenrock ◽  
M. Tannast
Keyword(s):  
Hip Dislocation ◽  
Acetabular Fractures ◽  
Surgical Hip Dislocation ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-term outcome after anterolateral open reduction and Salter osteotomy for late presenting developmental dysplasia of the hip

2018 ◽  
Vol 12 (4) ◽  
pp. 364-368 ◽  
Author(s):  
S. R. Y. W. Thomas
Keyword(s):  
Femoral Head ◽  
Open Reduction ◽  
Skeletal Maturity ◽  
Hip Dislocation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Femoral Head Osteonecrosis ◽  
Salter Osteotomy ◽  
Innominate Osteotomy

IntroductionOnly a handful of studies report outcomes after open reduction for developmental hip dislocation beyond skeletal maturity. For successfully reduced hips it is the outcome into late adulthood on which the results of this intervention should be judged. These studies indicate clearly the importance of preservation of the acetabular growth centres during surgery. The acetabulum must also be addressed when insufficient growth remains reliably to remodel residual dysplasia even after stable, concentric reduction.SummaryComparing the longest-term outcome studies for open reduction to less invasive, but mainly historical, techniques of gradual traction reduction it is unsettling to note that the latter protocols are associated with the best results. Whereas open reduction and innominate osteotomy are practised as originally described by Salter, gradual traction reduction has largely been abandoned.ConclusionsThere are probably aspects of the more time-consuming methods of gradual reduction that do not violate the hip joint capsule that expose the femoral head to a lower risk of femoral head osteonecrosis leading to better long-term outcomes.

Native hip dislocation at acetabular fracture predicts poor long-term outcome

Injury ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 1841-1847 ◽  
Author(s):  
J.A. Nicholson ◽  
C.E.H. Scott ◽  
J. Annan ◽  
I. Ahmed ◽  
J.F. Keating
Keyword(s):  
Acetabular Fracture ◽  
Hip Dislocation ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-term outcome of closed reduction in late-detected hip dislocation: 60 patients aged six to 36 months at diagnosis followed to a mean age of 58 years

2018 ◽  
Vol 12 (4) ◽  
pp. 369-374 ◽  
Author(s):  
T. Terjesen
Keyword(s):  
Risk Factors ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Patient Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Âgé

PurposeThe aims of this study on late-detected developmental dislocation of the hip (DDH) were to assess the outcome in patients aged 55 to 60 years and to define prognostic factors.MethodsThe study included 60 patients (74 hips). Primary treatment was skin traction to obtain closed reduction, followed by hip spica plaster cast. There were 52 girls and eight boys with a mean age at reduction of 19.6 months (8 to 37). Criteria for good long-term outcome were no osteoarthritis (OA) or total hip arthroplasty (THA) and modified Harris Hip Score ≥ 80 points.ResultsThe mean patient age at follow-up was 57.7 years (55 to 60). Good long-term clinical and radiographic outcome occurred in 39 of 73 hips (53%). In all, 24 hips (32%) had undergone THA at a mean patient age of 48.1 years (31 to 58). Survival analysis with conversion to THA as endpoint showed a reduction in survival from 100% at patient age 30 years to 62% at 58 years. Risk factors for poor outcome were age at reduction ≥ 1.5 years and residual dysplasia (Severin grades III/IV) at skeletal maturity.ConclusionWith a mean follow-up of patient age 58 years, the outcome of late-detected DDH, treated with traction and closed reduction, was satisfactory in more than half the hips. This indicates that the hip will probably last more than 50 years if risk factors like age at reduction ≥ 1.5 years, residual dysplasia and avascular necrosis are avoided.

Management and long-term outcome of pelvic fractures: a retrospective study of 43 cats

2016 ◽  
Vol 19 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Richard L Meeson ◽  
Alex T Geddes
Keyword(s):  
Complication Rate ◽  
Pelvic Fractures ◽  
Neurological Deficits ◽  
Acetabular Fractures ◽  
Clear Correlation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Width

Objectives The aim of the study was to evaluate the management and long-term outcome of cats with pelvic fractures. Methods Cats with pelvic fractures had their records and radiographs reviewed. Radiographs were reviewed for fracture configuration, implants and pelvic canal narrowing. Owners were contacted for long-term follow-up. Results Forty-three cats met the criteria (mean follow-up 24 months [range 6–45 months]). The majority (93%) had more than one orthopaedic pelvic injury, with sacroiliac fracture luxations seen most commonly; 23% had presurgical neurological deficits. Most cats (74%) were managed surgically; 60% of sacroiliac fracture luxations, 82% of ilial fractures and 50% of acetabular fractures received surgery. The complication rate was 22%, most commonly sciatic neurapraxia (13%). Seventy-nine percent of all neurological deficits resolved and the remainder improved. Mean pelvic canal narrowing after trauma was −15% in surgical and −16% in conservatively managed cats. Canal width was improved postoperatively (–8%) but mildly narrowed further by follow-up (–12%); however, these changes were not significant. Nineteen percent of cats had constipation postsurgery; none developed megacolon. There was no clear correlation between the degree of narrowing of the pelvic canal up to −50%, or whether conservative treatment was opted for, and the development of constipation. Long-term mobility was not impaired in 86% of cats, and 84% did not have any lameness detectable. Conclusions and relevance The majority of cats were managed surgically, with a 22% complication rate; the most common being transient sciatic neurapraxia. Long-term outcome was generally excellent and most had a full recovery. Constipation/obstipation was very uncommon and no clear relationship with pelvic canal narrowing could be found when considering narrowing of up to −50% in both surgical and conservative groups. As no cats in this cohort had narrowing greater than −50%, the current recommendation of surgery to improve the canal width if narrowing is greater than −45% to −50% should remain.

Management and Long-Term Outcome of Acetabular Fractures in Dogs: A Retrospective Study of 49 Dogs

2021 ◽  
Author(s):  
Victoria J. Roberts ◽  
Kevin Parsons ◽  
David Sajik ◽  
Richard L. Meeson
Keyword(s):  
Conservative Management ◽  
Brief Pain Inventory ◽  
Neurological Deficits ◽  
Acetabular Fractures ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Factors Affecting ◽  
Fracture Location ◽  
Long Term Follow Up

Abstract Objective The aim of this study was to categorize the presentation, management, complications and long-term outcome of canine acetabular fractures, and to determine the factors affecting outcome. Materials and Methods Case records and imaging for dogs with acetabular fractures were reviewed with long-term follow-up via canine brief pain inventory (CBPI) and owner questionnaires. Results The majority of fractures were in the mid-third (36/52) and caudal-third (13/52) with few in the cranial-third of the acetabulum (3/52). Concurrent injuries were diagnosed in 47/49 dogs; 10/34 dogs had neurological deficits on presentation. Forty-seven fractures received treatment: 25/47 had direct surgical repair (DSR), 10/47 had salvage surgery (SS) and 12/47 had conservative management (CM). Fracture location significantly affected treatment group (p = 0.001). New neurological deficits were documented after DSR in 5/24 dogs and SS in 2/10 dogs. Short-term complications occurred after DSR in 10/18 dogs (five minor, five major) and CM in 1/8 dogs (major). Long-term complications occurred after DSR in 2/15 dogs (major) and CM in 2/7 dogs (catastrophic). Conservative management dogs had worse average owner-reported CBPI scores than DSR or SS dogs. Clinical Significance Acetabular fractures predominate in the mid and caudal acetabulum, with high levels of concurrent injuries. Fracture location significantly influenced the treatment approach taken. Postoperative neurological deficits are common following SS and DSR.

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