Title : Evaluating the outcomes of surgical hip dislocation (SHD) for femoral head trauma: A systematic review
Abstract:
Femoral head fractures are uncommon but severe injuries typically resulting from high energy trauma and frequently associated with hip dislocation. Surgical Hip Dislocation (SHD), particularly the Ganz approach, provides circumferential access to the femoral head while preserving vascularity, enabling accurate reduction and fixation. This systematic review, conducted according to PRISMA 2020 guidelines, evaluated 10 studies comprising 267 patients treated with SHD for femoral head trauma.
Across the included studies, functional outcomes were consistently favourable, with most patients achieving good to excellent scores on validated hip function scales. Rates of avascular necrosis were low (0–8.3%), supporting the vascular safety of SHD. Pipkin type IV fractures demonstrated the poorest prognosis, with high rates of post traumatic arthritis and conversion to total hip arthroplasty. Heterotopic ossification was common but rarely symptomatic. Early hip reduction (<6 hours) was repeatedly associated with improved outcomes, underscoring the importance of timely intervention.
Overall, SHD appears to be a reliable and effective technique for managing femoral head trauma, offering excellent visualization, stable fixation, and favourable functional recovery. This review highlights prognostic factors influencing outcomes and supports SHD as a valuable option in selected complex hip injuries.
