Traumatic hip dislocation; a South East Nigeria hospital experience

Abstract

Background: Hip dislocation is a relatively common orthopaedic emergency. The hip is an inherently stable joint and substantial force is required for dislocation to occur. Thus hip dislocation is said to follow motor vehicle accidents with more than 90% of hip dislocations being posterior. Thompson and Epstein grade I and II are acknowledged to be the commonest grades of posterior hip dislocation. Method: This is a retrospective study involving all cases of traumatic hip dislocation seen at The National Orthopaedic Hospital, Enugu between 1st January 2004 and 31st December 2009.The records of the patients were obtained and the relevant data extracted. The data was analyzed to determine the pattern and management of hip dislocations. Results: A total of 67 patients were seen and treated within the study period. There were 48(69.6%) males and 21(30.4%) females giving a male to female ratio of 2.3:1. The mean age was 36.4 ± 14.6 years. Posterior hip dislocation was seen in 92.9% of cases. Thompson and Epstein grade I and II were seen in 63% of cases. Interval to presentation was variable and ranged from <6 hours (39.1%), within 12 hours (44.9%), to >13 weeks (7.2%). Associated neurological injury was present in 5.7% of patients. The commonest form of treatment was closed reduction in 76.8% of patients. Associated injuries occurred in 53.6% of patients with fractures of other bones in 23.2%. Most (88.4%) traumatic hip dislocations followed motor vehicular accident. Conclusion: Traumatic hip dislocation occurs in our environment and posterior dislocations are the commonest form. Thompson and Epstein I and II are common. Late presentation is common in our environment but closed reduction is the form of treatment in most cases. Associated injuries are frequently seen.