A Prospective Study of Management of Fracture Dislocation of Hip (PIPKIN) by Safe Surgical Dislocation (2 Years 6 Months Follow-Up in a Tertiary Hospital at Visakhapatnam)

Abstract

Appala Raju Sanaboyina1, Saraswathi Venkata Avula2

BACKGROUND
High velocity motor vehicle injuries are associated with hip fracture dislocations
especially dash board injuries. Most commonly posterior hip dislocations are
associated with occasional femoral head fractures. Computerized tomographic
imaging is done to look at the congruency of the hip joint. Safe surgical dislocation
or Ganz approach was described in 2001 for exposing the hip in a 360-degree view
without damaging the vascularity of the femoral head. In this study, we wanted
to evaluate the radiological and functional outcome using modified Merle d'
Aubigne-Postel and Harris hip scoring.
METHODS
The current study is a prospective study in a tertiary referral centre where 8 young
adult males were followed up for a period of 2 years 6 months from August 2018
to February 2021 after safe surgical dislocation and reduction with headless
Herbert screws to maintain congruent hip surface.
RESULTS
We had 1 patient with associated chest injury requiring intercostal tube placement,
while none of them had developed avascular necrosis or early arthritis. We had
used modified Merle d'Aubigne-Postel and Harris hip scoring to assess the
functional outcome. We had six patients with excellent results and two patients
with good outcome due to occasional pain. We followed all the patients for more
than 2 years. We evaluated the radiological and functional outcomes. The results
are comparable to other researcher’s studies.
CONCLUSIONS
Safe surgical dislocation is a very good choice for fixation of femoral head fractures
where the complications like early arthritis of femoral head and acetabulum are
less along with preserving the vascularity of the femoral head and preventing the
chances of avascular necrosis of femoral head. It also provides a good intraoperative
view for handling the fracture reduction.
 

image