Traumatic Hip Joint Dislocation Following Motor Vehicle Accidents

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 lead to significant economic burden. Moreover, since hip reduction can be done either in the emergency room (ER) or in the operating room (OR), it is important to understand the causes that lead to an OR reduction. This data can help the authorities to estimate the predicted expenses and to establish an evacuation algorithm. Thus, the objectives of this study are to examine the risk factors for an OR reduction and to review the epidemiologic data regarding THD.

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

Results: Of 119,710 MVA patients, 475 (0.4%) THD were identified. The only significant risk factor that has been found to lead to an OR reduction was admission to level II compared to level I trauma centers. In level I facilities 95/340 patients (27.9%) with THD were treated in the OR in comparison to 82/135 patients (60.7%) in level II facilities, (p<0.001). (Table 1). Most patients were males (77%) aged 15-29 (46.7%) and 90% of all THD had an additional injury.

Conclusion: The prevalence of THD in MVA is 0.4%. Admission to level II trauma center is associated with higher prevalence of OR reductions which may lead to unnecessary use of the OR staff and higher associated costs. Therefore, if the opportunity arises we recommend on directing and treating patients suffering from THD in level I trauma centers.