Luxations traumatiques de hanche : luxations pures et fractures de tête fémorale

Abstract

Traumatic hip dislocation refers to the permanent displacement of the femoral head, outside the acetabulum cavity. It may consist of a pure dislocation or may be associated with a fracture of the femoral head. It constitutes a severe lesion that is the consequence of an aggressive trauma, often associated with potential lesions that must be sought. Most of the time, the diagnosis is clinic. Front pelvis radiography is necessary and mandatory in case of polytrauma, in order to confirm the diagnosis, to identify the clinical type, and to screen for a fragment of the femoral head in the joint. Traumatic hip dislocation constitutes a therapeutic emergency that necessitates a setting of the dislocation under good anaesthetic conditions. Femoral head fractures also constitute emergency cases but the therapeutic decision making is debated. Two principles remain very important: the setting of the dislocation without any strength manoeuvre, and the preservation and surgical repositioning of the femoral head fragment in case it has been displaced after the dislocation reduction. Considerable complications exist, mainly a risk for osteoarthritis and post-traumatic necrosis.