SEVERITY OF INJURIES ASSOCIATED WITH TRAUMATIC HIP DISLOCATIONS AS A RESULT OF MOTOR VEHICLE ACCIDENTS

Participants: D.J. Hak, J.A. Goulet

Keywords: traumatic hip dislocation, motor vehicle accidents

Introduction

Previous reports have shown a high rate of associated injuries in patients sustaining a traumatic hip dislocation. Since these earlier reports improvements have been made in passenger safety systems and the rate of restraint usage has increased. The purpose of this study was to review the associated injuries present in a current series of patients sustaining a traumatic hip dislocation as a result of a motor vehicle accident.

Materials and Methods

We retrospectively reviewed our trauma registry identifying sixty-six patients who sustained traumatic hip dislocations as a result of motor vehicle accidents. Thirty patients (45%) were restrained and thirty-six (55%) were unrestrained. Airbags were known to have deployed in fourteen cases.

Results

The incidence of associated injuries was 95% (63 patients). Orthopaedic injuries alone were seen in twenty-two patients (33%), while other associated injuries were seen in forty-four patients (67%). Abdominal injuries were present in ten patients (15%), thoracic injuries were present in fourteen patients (21%), closed head injuries were present in sixteen patients (24%), and craniofacial injuries were present in fourteen patients (21%). Acetabular fractures were seen in forty-six patients (70%), femoral head fractures were identified in nine patients (14%), and other extremity fractures occurred in twenty-six patients (39%). The average Injury Severity Score (ISS) for all patients was 17.4 (range 9 to 59). The average ISS of the restrained patients was not statistically different than the unrestrained patients (p < 0.491).

Conclusions

Although improvements in automotive safety features and restraint usage have occurred since previous reports there continues to be high rate of severe injuries associated with traumatic hip dislocations that occur in motor vehicle accidents. We believe that all patients sustaining a traumatic hip dislocation warrant a general surgery trauma evaluation to rule out any potential associated injuries.