Surgical Hanagement Of Posterior Fracture Dislocation Of The Hip Joint:

Hassan Hussein Ahmed

SU””Jl’.RYPosterior fracture-dislocation of the hip is an intra-articularfracture. Displaced fragMnt and hip dislocation should be reducedanatom.caaly for the sake of !JfItting the best possible results.It is always a part of _jor accident involving IIore than oneserious injury.The cc.plicated anat~ of the hip bone and its vital relatiolllS.ue a precise diagDOsisof the fractured part IIIIJIdatoryto .ueproper s1lr9ical procedure.TheX-ray ~ing in the fOl”ll of antero-posterior and obliquevievs and CTseaning is Dportant. to !JfItaccurate diagnosis.Thenextensive pre opeIative planning is Dportant..The dislocated hip is considered a lI1Ir9icalm r!Jflnc:yand should bereduced within t-ty four hours to reduce the incidence of avascular_is and dey_ative arthritis of the hip. Bat the operationitself can be delaJed till the optt.8 conditions are justified. andthe delay should not exceed two weeks.-144-In this thesis _ perfOl’llopen reduction and internal fixation fort_nty five patients with posterior fracture-dislocation of the hipwith the result of ~ satisfactory results and 201 unsatisfactoryresults.The Cc.pl1catiODS encountered are avascular necrosis anddegenerative arthritis of the hip in 1ft due to late operativeinterference, ~sitis ossificans in ., sciatic uerYepal.y in ••Bachpatient ••••••• sed bf geDeIal •••••tnation to detect and.aDllgeany associated anjuri... Traction to the affected liab •• doneas a first aid and then X-ray •• daDe. ’!!Ie di.located hips _rereduced as an _tra1genc..p..r,occy:’”eclureand then the patient prepared for_jor sIlg_}’.’!!Ienitable IIIJIlI”OBiC. hthe posterior Xoc:ker-Langenheclatpproach,ach1... nt of _tomcal recIuct10nand stable internal fixation isPost-operative ph}’aiotherapy i. helpfull in regaining norMl hip-145-fwx:tioD.llearly aDdweight bearing should be postpoDdtill soUDdunionoccur.The pollibility of baving a no~l hip is of high percentage afterthis regiM.