TY  - JOUR
PY  - 2023//
TI  - Epidemiology and injury morphology of traumatic hip dislocations in children and adolescents in Germany: a multi-centre study
JO  - European journal of trauma and emergency surgery
A1  - Braun, Mirjam Evi
A1  - Loose, Oliver
A1  - Schmittenbecher, Peter
A1  - Schneidmüller, Dorien
A1  - Strüwind, Christoph
A1  - Schwerk, Philipp
A1  - Reineke, Sebastian
A1  - Traub, Frank
A1  - Ihle, Christian
A1  - Lieber, Justus
A1  - Rüther, Hauke
A1  - Baumann, Florian
A1  - Marzi, Ingo
A1  - Tüshaus, Ludger
A1  - Adrian, Miriam
A1  - Bergmann, Florian
A1  - Graf, Alexander
A1  - Kaiser, Martin
A1  - Fernandez, Francisco Fernandez
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: Traumatic hip dislocations are very rare in childhood and adolescence. The aim of this multi-centre study is to analyse the current epidemiology and injury morphology of a large number of traumatic hip dislocations in children. This can provide a better understanding of childhood hip dislocations and contribute to the development of a therapeutic approach in order to prevent long-term impacts. <br><br>METHODOLOGY: This retrospective, anonymised multi-centre study included patients, aged up to 17 years, with acute traumatic hip dislocations and open growth plates. The patients came from 16 German hospitals. Exclusion criteria included insufficient data, a positive history of hip dysplasia, or an association with syndromal, neurological or connective tissue diseases predisposing to hip dislocation. An analysis was carried out on the patients' anthropometric data and scans (X-ray, MRI, CT), which were collected between 1979 and 2021. Gender, age at the time of dislocation, associated fractures, mechanism of injury, initial treatment including time between dislocation and reduction, method of reduction, treatment algorithm following reduction and all documented complications and concomitant injuries were evaluated. <br><br>RESULTS: Seventy-six patients met the inclusion criteria. There were two age peaks at 4-8 years and 11-15 years. There was an increased incidence of girls in the under-eight age group, who had mild trauma, and in the group of over-eights there were more boys, who had moderate and severe trauma. Dorsal dislocation occurred in 89.9% of cases. Mono-injuries dominated across all age groups. Concomitant injuries rarely occurred before the age of eight; however, they increased with increasing ossification of the acetabulum and appeared as avulsion injuries in 32% of 11-15-year-olds. Of the 76 patients, 4 underwent a spontaneous, 67 a closed and 5 a primary open reduction. A reduction was performed within 6 h on 84% of the children; however, in around 10% of cases a reduction was not performed until after 24 h. Concomitant injuries needing intervention were identified in 34 children following reduction. Complications included nerve irritation in the form of sensitivity disorders (n = 6) as well as avascular necrosis (AVN) of the femoral head in 15.8% of the patients (n = 12). <br><br>CONCLUSIONS: Traumatic hip dislocations are rare in childhood and adolescence and have high complication rates. The most severe complication, femoral head necrosis, occurred in 16% of cases. Minor injuries, especially in younger children, are enough to cause a dislocation. Posterior dislocation was more frequent and primarily occurred as a mono-injury; however, concomitant injuries must be considered with increasing age. Children continue to experience delayed reductions. The length of time until reduction, age and the severity of the concomitant injury play a role in the development of femoral head necrosis; however, this topic requires additional investigation.<p />  <p>Language: en</p>
LA  - en
SN  - 1863-9933
UR  - http://dx.doi.org/10.1007/s00068-023-02280-2
ID  - ref1
ER  -