Lu Xiaokun,Wang Jiansi,Zeng Huiyi,et al.Short-term follow-ups of traumatic hip dislocation in children:a single-center retrospective study[J].Journal of Clinical Pediatric Surgery,,():811-815.[doi:10.3760/cma.j.cn101785-20260106-00008]
Short-term follow-ups of traumatic hip dislocation in children:a single-center retrospective study
- Keywords:
- Traumatic Hip Dislocation; Hip Fracture; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the clinical characteristics of traumatic hip dislocation (THD) in children and summarize the short-term follow-up results after treatment.Methods A retrospective review of clinical data was performed for 20 children with traumatic hip dislocation hospitalized at the Department of Pediatric Orthopedics,Quanzhou Orthopedic-traumatological Hospital from January 2016 to March 2023.Gender,age,affected side,fracture type,concurrent fractures,injury mechanism,reduction mode,reduction timing,treatment protocols after reduction and complications were recorded.At the final follow-up,clinical efficacy was evaluated by avascular necrosis of femoral head (AVN),Barquet classification and Harris hip score.Results After excluding cerebral palsy (n=3),congenital hip dysplasia (n=1) and lost to follow-up (n=2).The reminders (n=14) were finally recruited.The average follow-up period was 2.6(1.5-5.4) year.There were 9 boys and 5 girls with an average age of 9.5(1.3-13.8) year.The affected side was left (n=8) and right (n=6). Among the 14 cases,11 cases were reset within 6 hours after injury, and no AVN occurred (incidence rate 0%); Three cases were reduced after more than 6 hours of injury,and two cases developed AVN (incidence rate 66.7%); There was a statistically significant difference in the incidence of AVN between the two groups (P=0.033). There were 6 cases of high-energy injuries (falls from heights & automobile accidents) with an average age of 13.3(10.8,13.5) year and 8 cases of low-energy injury with an average age of 6.1 (4.4,13.0) years.No statistically significant inter-group difference existed in age (Z=-1.617,P=0.106).All of them belonged to posterior dislocation of hip joint.Among them,there were 6 cases of simple dislocation (without concomitant injury) with an average age of 4.7(3.3,5.8) year and an age range of (1.3-6.8) year.Eight cases of concurrent injuries were reported with an average age of 13.3(13.0,13.7) year and an age range of (12.9-14.0) year.The inter-group age difference was statistically significant (Z=-3.105,P= 0.002).Closed reduction was performed (n=9) and 1/9 underwent joint arthroscopic exploration and cleaning after closed reduction.Another 5 were treated with routine open reduction.Fixing with hip herringbone plaster or brace was implemented for 4-6 weeks after reduction.Reset occurred within 6 hours after injury (n=11) and after 6 hours (n=3).The incidence of AVN was 0% and 66.7% in two groups and there was statistically significant difference (P=0.033).Gender,age,affected side,reduction mode and injury mechanism had no significant effect on the incidence of AVN (P>0.05).At the last follow-up,Barquet classification was type Ⅰ (n=11),type Ⅱ (n=1),type Ⅲ/Ⅳ (n=0) and type Ⅴ (n=2).Ischemic necrosis of femoral head occurred (n=2).Both were caused by high-energy injury.After open reduction,reduction time lasted over 6 hours.At the last follow-up,Harris hip joint score was excellent (n=12),decent (n=1) and poor (n=1).Conclusions The incidence of THD is low in children and adolescents.It is predominantly posterior dislocation.Reduction time after injury >6 hours may significantly elevate the risk of ischemic necrosis of femoral head.And early reduction is essential for achieving a better prognosis.Adolescents are prone to such complications as femoral head and acetabular fractures.Patients who achieved anatomical center reduction without experiencing ischemic necrosis of femoral head have satisfactory short-term follow-up outcomes.
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收稿日期:2026-1-6。
通讯作者:李炳钻,Email:1423037870@qq.com