A review of the treatment of hip dislocations associated with acetabular fractures

Traumatic dislocation of the hip is an extremely severe injury. Although pr eviously considered an uncommon lesion, it now is seen more often as a resu lt of motor vehicle accidents. In most cases, dislocation of the hip is ass ociated with fractures of the acetabulum, which ultimately can result in a higher incidence of complications than the complications observed in pure s imple dislocations. Early recognition and prompt closed reduction of the di slocated hip constitute the cornerstone of proper treatment of this injury. Once the dislocation is reduced, definitive treatment of the acetabular fr acture can be delayed to obtain a precise diagnostic evaluation. If surgica l reconstruction of the acetabular fracture is indicated, it is done best i n the first 10 days after the injury. A few patients in whom nonconcentric reduction, failed closed reduction, or impaired neurologic status occurs af ter reduction will require early open reduction and internal fixation of th e fracture. Complications can be caused by the initial injury or by the tre atment. Avascular necrosis of the femoral head, degenerative osteoarthritis , and heterotopic ossification are the main complications encountered in pa tients with unsatisfactory final results. Despite a perfect reduction of th e hip dislocation and anatomic reduction of the acetabular fracture, a sign ificant degenerative process of the hip is expected when the patient is ass essed at long-term followup.