Abstract
Objective: A floating hip, e.i. combination of pelvic or acetabulat fracture with ipsilateral femoral fracture is uncommon condition, but posing considerable problems such as how to manage each component of the injury and what are the treatment priorities. The aim of the syudy is to report our experience with surgical treatment of traumatic floating hip.
Material and methods: For the 4-year period in our institution 15 patients with floating hips (10 mails, 5 females, average age 38 years) were treated operatively. There were 10 unstable pelvic ring disruptions B and C types and 5 displaced acetabular fractures, combined with 2 neck, 11 shaft and 2 supracondylar femoral fractures. Six patients were operated simultaneously for both components and in the rest definitive pelvic surgery were done at a second stage. pelvic girdle was stabilized by a variety of methods: anterior sacro-iliac plates, iliosacral lag screws, transsacral posterior plaates. Acetabular fractures were all treated by ORIF. For femoral fractures nailing was done in 8 cases, plating in 5 and cervical screw fixation in 2.
Results: All fractures healed in time. Two superficial femoral infections resolved after local care. Results for pelvic injuries were estimated according to Pholemann score and for acetabular fractures – to Matta scale. In respect to pelvic fractures 5 ecxellent, 3 good and 2 poor results were noted, and regarding acetabular fractures 3 exccelent, 1 satisfactory and 1 poore results. All femoral fractures united in good position. Overall final outcome was excellent in 8, good in 3, fair in 1 and poor in 3 patients.
Conclusions: Surgical treatment is a method of choice for a floating hip. ORIF of pelvic ring and locking nailing of the femur result in best outcome. Simultaneous procedure provides more rapid recovery, but should be carried out only in stable patients. If staged surgery is planned, stabilisation of the femur should be done prior to definitive pelvic fixation in order to facilitate later pelvic surgery.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
