Журнал травм и лечения

Old Coxofemoral Dislocation Treated by Hip Arthroplasty

Abstract

Arabo Saidou1,2*, Batchom Alphonse3, Fokam Pius4 and Farikou Ibrahima2

Introduction: Hip dislocation is frequent in our context. It becomes old if the reduction is not made after 28 days. The aim of the work is to assess their frequency and the difficulty of their management, then to assess functionally the fate of this hip after arthroplasty.

Materials and Methods: We carried out a prospective and descriptive study from January 2016 to December 2020 at the Laquintinie hospital in Douala and the Garoua Regional Hospital. We collected a total of 25 cases (22 patients with an old dislocation and 3 cases of neglected hip dislocation) including 15 men and 10 women; we performed uncemented total hip arthroplasty in 9 patients. With an average follow-up of 26 months, we evaluated these 9 patients by the numerical PMA evaluation score (Postel Merle d'Aubigné).

Results: Men were the most numerous (15/10). The left hip was the most injured (13/12). All patients presented with a high posterior dislocation. The average score is 15 out of 18. 2 operated patients had a very good result and 7 a good result.

Discussion: If hip dislocations are not reduced on time, their management becomes complex and can lead to total hip arthroplasty straight away. This is complicated by osteonecrosis of the femoral head or paralysis of the sciatic nerve. Some authors suggest the realization of a total hip replacement regardless of the patient's age. The low rate of operated patients may constitute a limitation for our study. The major part of our patients could not be operated due to lack of financial means, the health insurance not being effective. The results of the 9 operated patients were satisfactory after hip arthroplasty, we believe that we made the best choice by immediately proposing a hip arthroplasty.

Conclusion: Old hip dislocations exist in our environment and are frequent. First-line total hip arthroplasty is the best indication to restore autonomy to the patient.