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Topic:

Hip Dislocation

Issue:

Hip

Category:

Trauma

Title:

Clinical Outcomes and Associated Pathologies Following Pediatric Traumatic Hip Dislocations: A Systematic Review of the Literature

Author:

Baumann, Anthony N. DPT; Ndjonko, Laura C.M.; Schoenecker, Jonathan G. MD, PhD; Baldwin, Keith D. MD, MSPT, MPH

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e97-e105, DOI: 10.1097/BPO.0000000000002563

Level Of Evidence:

III

# of Patients:

575

Study Type:

Systematic Review

Location:

Not specified

Summary:

This systematic review evaluates the outcomes, frequency of dislocation direction, reduction type, and the rate of associated pathologies (APs) in pediatric traumatic hip dislocations. The study found that pediatric hip dislocations are primarily posterior, with a high rate of long-term adverse events (LTAEs) and associated injuries (AIs), particularly avascular necrosis (AVN).

Methods:

A systematic review was conducted using databases like PubMed, ScienceDirect, Web of Science, CINAHL, and MEDLINE. Inclusion criteria were full-text English articles addressing pediatric traumatic hip dislocations in patients under 18 years.

Exclusions:

Studies not in English, or those without full text.

Results:

The average patient age was 9.5 years, with a follow-up time averaging 74 months. The most common dislocation direction was posterior (86.4%). Closed reduction was the most common treatment (84.5%). 15.5% of patients experienced avascular necrosis (AVN), while 14% had labral/capsular injuries and 9.4% had acetabular fractures. Overall, 72% of patients (414 out of 575) experienced associated pathologies (APs).

Conclusions:

Pediatric traumatic hip dislocations are linked to a high incidence of associated injuries and long-term adverse events. AVN, labral/capsular injuries, and acetabular fractures are the most common post-dislocation pathologies. Posterior dislocations are the most frequent, and closed reduction is the typical management approach.

Relevance:

Limitations:

Perspective:

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