FRACTURE-DISLOCATIONS OF THE HIP JOINT

¹ Division of Bone and Joint Surgery, Stanford University School of Medicine, San Francisco

A review of the literature shows that posterior dislocation of the hip with associated fracture of the acetabular lip is comparatively uncommon.

It is characteristically an "automobile injury" and hence is increasing in frequency.

Without perfect reduction, arthritic disintegration of the joint occurs rapidly, due to mechanical incongruity of joint surfaces.

Roentgenograms of good quality must be studied with great care before the reduction is accepted.

Open "reduction" is indicated when:

1. The lip fragment is large and does not come down into position when the head is reduced (unstable reduction).

2. The lip fragment is in the acetabulum.

3. Sprain fracture of the head prevents perfect reduction.

4. A fracture through the acetabular floor allows rotation of the distal fragment which prevents reduction.

5. Femoral shaft fracture prevents control of the head.

The author has obtained satisfactory reduction by this operation.

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