1: J Orthop Trauma  2002 Sep;16(8):543-52 

Surgical dislocation of the femoral head for joint debridement and accurate
reduction of fractures of the acetabulum.

Siebenrock KA, Gautier E, Woo AK, Ganz R.

Department of Orthopaedic Surgery, University of Berne, Switzerland.
klause.sidenrock@insel.ch

OBJECTIVES: To evaluate fracture reduction, femoral head viability, and outcome
of selected acetabular fractures treated operatively using a modified
Kocher-Langenbeck approach with a trochanteric flip osteotomy and surgical
dislocation of the femoral head. DESIGN: Prospective. PATIENTS: Twelve patients
predominantly with combined transverse and posterior wall fractures or
multifragmentary posterior wall fractures. OUTCOME EVALUATION: Clinical and
radiographic analysis after a minimum 2-year follow-up. METHODS: A single
modified approach, including anterior ( = 8) or posterior ( = 4) surgical
dislocation of the femoral head, was done in 12 patients for one or more of
following reasons: intra-articular assessment of reduction in fractures with
comminution, marginal impaction and involvement of the anterior column, removal
of intra-articular fragments, and confirmation of extra-articular screw
placement. RESULTS: At a mean follow-up of 35 months (24-48 months), the 12
patients presented with a good to excellent clinical result according to the
D'Aubigne score. One patient developed postoperative osteoarthritic changes
after an imperfect reduction. No heterotopic ossification interfering with hip
function was found. None of the hip joints developed signs of avascular necrosis
of the femoral head, even though seven patients sustained a posterior
dislocation at time of the injury. CONCLUSION: This study indicates that this
technique for surgical dislocation of the femoral head is safe and facilitates
assessment of fracture reduction in selected acetabular fractures.

PMID: 12352562 [PubMed - in process]