TITLE:
Profile of Traumatic Hip Dislocations in a West African Teaching Hospital
AUTHORS:
Patrick W. H. Dakouré, Malick Diallo, Thierry A. W. Guigma, Massadiami Soulama, Salifou Gandéma
KEYWORDS:
Developing Country, Dislocation, Hip, Motorcycle, Traumatic
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.7 No.11,
November
9,
2017
ABSTRACT: Purpose: Traumatic hip dislocations (THD) are rarely reported from developing countries.
The aim of the current study is to describe the trauma, the presentation, the
treatment and the outcome patterns of THD received in the trauma unit of an
emergency department (ED) in west Africa. Patients and Methods: A
retrospective ongoing study from 2008 to 2014 was performed at the ED. All
patients over 15 years with an unreduced THD and an anteroposterior pelvic
radiograph were studied. Data were collected and analyzed by means of a
statistical software. Results: A total of 50 THD were included in the study. We
found an average of seven dislocations per year with a mean age of 36 years
mainly males (n = 37). Road traffic accidents by motorcycle (n = 20) were the common circumstance
of trauma. Forty-five extra-pelvic THD were diagnosed. According to the Bigelow
classification, THD were classified posterior (n = 33), anterior (n = 10) and
irregular (n = 2). Associated acetabular fractures (n = 36), ipsilateral lower
limb fractures (n = 10) and sciatic nerve palsy (n = 2) were also found. The
THD cases were treated by closed reduction (n = 34), open reduction (n = 6) and
Girdlestone procedure (n = 1). The outcome after 16 months showed 21 good and
excellent functional results and one death.
The short term complications were post traumatic arthritis (n = 10) and
osteonecrosis (n = 2). Conclusion: The THD occurrences are important in
our emergency department. They are characterized by the place of motorcycle
accidents and by the delayed reduction due to hospital’s locations and numbers
and beliefs. A reduction before four hours, an earlier rehabilitation, a
non-use of traction and a short hospitalization time below 14 days gave better
results.