Evaluation of management outcome of traumatic dislocation of the hip at Kenyatta National Hospital

Abstract

A cross sectional comparative study was carried out at Kenyatta National Hospital. The aim was to review the management of traumatic dislocation of the hip. One hundred and ten patients were included in the study. The maximum duration of follow-up was 4 years. Their age ranged between 3 years and 71 years; 75.5% [83 patients] of the patients were males while 24.5% [27 patients] were females. Most injuries were sustained from road traffic accidents, 79.3%. The commonest type of dislocation was posterior dislocation 62.7% [ 69 patients] followed by central dislocation 23.6%. [26 patients]. Ninety two patients, [83.6percent] were managed conservatively by traction after successful closed reduction and 18 patients (16.4%) by operative intervention. Of the 18 patients who underwent various operative procedures after failed closed reduction ,12 patients(66.7%) had open reduction and relocation,2 patients(11.1 %) had arthrodesis, 2 patients(11.1 %) had total hip replacement,2 patients(11.1 %) had acetabular reconstruction performed. Seventy mne patients, [71.8percent] recovered fully without any complications. Overall, the commonest complication occurring alone or in combination was osteoarthritis occurring in 20% [22 patients] of the patients, followed by avascular necrosis of the femoral head, 17.3 % [ 19 patients]. Sciatic nerve injury was found in 3patients (2.7%) of the patients. Mortality during the first 14 days stood at 1.8 percent [2 patients I, one of whom died of pulmonary embolism as shown at postmortem. Education and law enforcement on the use of seat belts will go a long way to reduce this problem as (87%) 56 people who were in automobiles at the time of the road traffic accident did not have seat belts on.