Traumatic Hip Dislocation, Risk Factors for Reduction in the Operation Room, An Epidemiologic Study

Background: The prevalence of traumatic hip dislocation (THD) appears to be on the rise. THD can lead to short and long term complications and may cause major economic burden. Therefore a review of it`s epidemiology, which has not been reported in detail yet, is of great importance. Moreover, since hip reduction can be done either in the emergency room (ER) or the operating room (OR) it is important to understand the causes that may lead to OR reduction. The objective of this study is to examine the risk factors that lead to OR reduction and to review the epidemiologic and demographic data regarding THD.

Methods: A retrospective evaluation of patients who were involved in MVA and admitted to the ER in Israel between 1997-2014. The data was recorded by a centralized country trauma database. Data related to the hospital`s trauma status (level I/II), the reduction, gender, age, associated injuries and injury severity score was gathered and analyzed.

Results: Of 119,710 MVA patients, 475 (0.003%) had a THD. Admission to level II compared to level I centers is the only risk factor for OR reduction. In level I facilities 95/340 patients (27.94%) with THD were treated in the OR in comparison to 82/135 patients (60.74%) in level II facilities, (p<0.001). (Table 1). Most patients were males (77%). The group age of 15-29 (46.7%) was the largest. 90% had an additional injury. Car drivers were involved in 182/475 (38.31%) with a male predominance of 85% (p=0.001). Car passengers formed the second largest group 136/475 (28.63%) with a female predominance of 57.8% (p<0.001).

Conclusion: This study contributes the largest database reported on traumatic hip dislocations following a MVA. Admission to level II trauma center is associated with higher prevalence of OR reduction which may lead to loss of OR time and higher costs.