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Journal of Bone and Joint Surgery, 1961;43:1079-1098.
© 1961 by The Journal of Bone and Joint Surgery, Inc


Posterior Fracture-Dislocations of the Hip

Comparison of Open and Closed Methods of Treatment in Certain Types

Herman C. Epstein M.D.1

1 Beverly Hills, California

A survey of 204 cases of traumatic fracture-dislocation of the hip, covering a period of twenty-one years, was published in 1951. In this series the dislocations and fracture-dislocations were divided into five types. Excellent results occurred only in Type I injuries, the simple dislocations without fracture.

Because of the unsatisfactory results that followed treatment in the fracture-dislocations, Types II, III, IV, and V, a different approach to these serious injuries was considered.

In certain instances there was reason to believe that there were loose fragments within the joint, many of which were not visualized by roentgenogram. Therefore, open reduction was advised in these fracture-dislocations, with the hope that removal of loose fragments and stabilization of an unstable hip joint could delay the appearance of traumatic arthritis and minimize its severity.

In this new series, fifty-five fracture-dislocations had adequate follow-up. Sixteen were treated by closed manipulation and thirty-nine by open reduction. Primary open reduction was performed in twenty-three cases. A comparison of the 1951 survey and the present series would seem to indicate that the results after primary open reductions are superior.


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