Floating Hip: Comparative Analysis of Outcomes and Associated Injuries
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Published:
Apr 18, 2022
Keywords:
Floating hip, associated injuries, high energy trauma, pelvis, acetabulum
Main Article Content
Abstract
Objective: We aim to describe the lengths of hospitalization, surgery, and rehabilitation of a series of patients with floating hip. As a secondary objective, to compare the outcomes obtained in terms of return to work in patients who had suffered fractures of the pelvis or acetabulum without an associated femoral fracture.
Materials and Methods: Descriptive, retrospective, and multicenter study of patients with high-energy trauma to the pelvis and acetabulum divided into two study populations according to the presence of associated ipsilateral femur fracture (floating hip) for comparison, during the period January 2014 – March 2019.
Results: 102 patients with pelvis and/or acetabulum trauma were included, grouped into 2 populations according to the presence of a floating hip (Floating hip: 23 patients; Pelvis/acetabulum: 79 patients). The median days of hospitalization [floating hip: median=15.5 (range=4-193); pelvis/acetabulum: 7 (3-31); p = 0.0001] and the number of surgeries per patient [FH: median = 5 (range = 3-8); pelvis/acetabulum: 2 (1-4); p = 0.0001] were higher in patients with floating hip. Additionally, temporary work disability was higher(p = 0.00012), with no significant differences in the rate of job retraining (p = 0.11).
Conclusion: Floating hip significantly increased the length of hospitalization, necessary surgical procedures, and recovery times according to temporary work disability in patients with trauma to the pelvis and/or acetabulum.
Materials and Methods: Descriptive, retrospective, and multicenter study of patients with high-energy trauma to the pelvis and acetabulum divided into two study populations according to the presence of associated ipsilateral femur fracture (floating hip) for comparison, during the period January 2014 – March 2019.
Results: 102 patients with pelvis and/or acetabulum trauma were included, grouped into 2 populations according to the presence of a floating hip (Floating hip: 23 patients; Pelvis/acetabulum: 79 patients). The median days of hospitalization [floating hip: median=15.5 (range=4-193); pelvis/acetabulum: 7 (3-31); p = 0.0001] and the number of surgeries per patient [FH: median = 5 (range = 3-8); pelvis/acetabulum: 2 (1-4); p = 0.0001] were higher in patients with floating hip. Additionally, temporary work disability was higher(p = 0.00012), with no significant differences in the rate of job retraining (p = 0.11).
Conclusion: Floating hip significantly increased the length of hospitalization, necessary surgical procedures, and recovery times according to temporary work disability in patients with trauma to the pelvis and/or acetabulum.
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How to Cite
Fuentes, E. E., Svarzchtein, S., Ricciardi, G., Cid Casteulani, A., Amadei Enghelmayer , R., Chiodini, M., Giacobbe, L., & Sasaki, S. (2022). Floating Hip: Comparative Analysis of Outcomes and Associated Injuries. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(2), 152-164. https://doi.org/10.15417/issn.1852-7434.2022.87.2.1422
Section
Clinical Research
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References
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J Bone Joint Surg Br 1992;74(1):93-100. https:://doi.org/10.1302/0301-620X.74B1.1732275
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2002;33(8):717-22. https://doi.org/10.1016/s0020-1383(01)00204-2
4. Zamora-Navas P, Guerado E. Vascular complications in floating hip. Hip Int 2010;20(Suppl 7):S11-8.
https://doi.org/10.5301/HIP.2010.4300
5. Tiedeken NC, Saldanha V, Handal J, Raphael J. The irreducible floating hip: a unique presentation of a rare injury. J Surg Case Rep 2013;2013(10):rjt075. https://doi.org/10.1093/jscr/rjt075
6. Tornetta P 3rd, Dickson K, Matta JM. Outcome of rotationally unstable pelvic ring injuries treated operatively. Clin Orthop Relat Res 1996;(329):147-51. https://doi.org/10.1097/00003086-199608000-00018
7. Johnson KD, Cadambi A, Seibert GB. Incidence of adult respiratory distress syndrome in patients with multiple
musculoskeletal injuries: effect of early operative stabilization of fractures. J Trauma 1985;25(5):375-84.
https://doi.org/10.1097/00005373-198505000-00001
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https://doi.org/10.5435/00124635-199901000-00006
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11. Tile M. Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 1988;70(1):1-12.
https://doi.org/10.1302/0301-620X.70B1.3276697
12. Giannoudis P, Jones AL, Malkani AL, PapeHC, Rodriguez J. Damage control orthopaedics: New approaches in
orthopaedic traumatology to the isolated extremity injury and polytrauma. Chicago, IL: Instructional Course in
Trauma Number: 374. AAOS 73th Annual meeting; 2006 March 22-25. Chicago, Illinios, USA: American Academy
Orthopaedic Surgeons.
13. Routt ML Jr, Simonian PT. Closed reduction and percutaneous skeletal fixation of sacral fractures. Clin Orthop
Relat Res 1996;(329):121-8. https://doi.org/10.1097/00003086-199608000-00015
14. Müller EJ, Siebenrock K, Ekkernkamp A, Ganz R, Muhr G. Ipsilateral fractures of the pelvis and the femur--floating hip? A retrospective analysis of 42 cases. Arch Orthop Trauma Surg 1999;119(3-4):179-82.
https//doi.org/10.1007/s004020050385
15. Ogura H, Tanaka H, Koh T, Hashiguchi N, Kuwagata Y, Hosotsubo H, et al. Priming, second-hit priming, and
apoptosis in leukocytes from trauma patients. J Trauma 1999;46(5):774-81; discussion 781-3.
https://doi.org/10.1097/00005373-199905000-00004
16. Christensen MC, Banner C, Lefering R, Vallejo-Torres L, Morris S. Quality of life after severe trauma: results from the global trauma trial with recombinant Factor VII. J Trauma 2011;70(6):1524-31. https://doi.org/10.1097/TA.0b013e3181f053c2
17. Zamora-Navas P, Estades-Rubio FJ, Cano JR, Guerado E. Floating hip and associated injuries. Injury 2017;48(Suppl 6):S75-S80. https://doi.org/10.1016/S0020-1383(17)30798-2
18. Burd TA, Hughes MS, Anglen JO. The floating hip: complications and outcomes. J Trauma 2008;64(2):442-8.
https://doi.org/10.1097/TA.0b013e31815eba69
19. Iotov A, Tzachev N, Enchev D, Baltov A. Operative treatment of the floating hip. Orthopaedic Proceedings
2018;88(Suppl 1):160. Disponible en: https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.88BSUPP_I.0880160c
2. Liebergall M, Lowe J, Whitelaw GP, Wetzler MJ, Segal D. The floating hip. Ipsilateral pelvic and femoral fractures.
J Bone Joint Surg Br 1992;74(1):93-100. https:://doi.org/10.1302/0301-620X.74B1.1732275
3. Liebergall M, Mosheiff R, Safran O, Peyser A, Segal D. The floating hip injury: patterns of injury. Injury
2002;33(8):717-22. https://doi.org/10.1016/s0020-1383(01)00204-2
4. Zamora-Navas P, Guerado E. Vascular complications in floating hip. Hip Int 2010;20(Suppl 7):S11-8.
https://doi.org/10.5301/HIP.2010.4300
5. Tiedeken NC, Saldanha V, Handal J, Raphael J. The irreducible floating hip: a unique presentation of a rare injury. J Surg Case Rep 2013;2013(10):rjt075. https://doi.org/10.1093/jscr/rjt075
6. Tornetta P 3rd, Dickson K, Matta JM. Outcome of rotationally unstable pelvic ring injuries treated operatively. Clin Orthop Relat Res 1996;(329):147-51. https://doi.org/10.1097/00003086-199608000-00018
7. Johnson KD, Cadambi A, Seibert GB. Incidence of adult respiratory distress syndrome in patients with multiple
musculoskeletal injuries: effect of early operative stabilization of fractures. J Trauma 1985;25(5):375-84.
https://doi.org/10.1097/00005373-198505000-00001
8. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 1996;78(11):1632-45. PMID: 8934477
9. Baumgaertner MR. Fractures of the posterior wall of the acetabulum. J Am Acad Orthop Surg 1999;7(1):54-65.
https://doi.org/10.5435/00124635-199901000-00006
10. Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 1964;46:1615-46. PMID: 14239854
11. Tile M. Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 1988;70(1):1-12.
https://doi.org/10.1302/0301-620X.70B1.3276697
12. Giannoudis P, Jones AL, Malkani AL, PapeHC, Rodriguez J. Damage control orthopaedics: New approaches in
orthopaedic traumatology to the isolated extremity injury and polytrauma. Chicago, IL: Instructional Course in
Trauma Number: 374. AAOS 73th Annual meeting; 2006 March 22-25. Chicago, Illinios, USA: American Academy
Orthopaedic Surgeons.
13. Routt ML Jr, Simonian PT. Closed reduction and percutaneous skeletal fixation of sacral fractures. Clin Orthop
Relat Res 1996;(329):121-8. https://doi.org/10.1097/00003086-199608000-00015
14. Müller EJ, Siebenrock K, Ekkernkamp A, Ganz R, Muhr G. Ipsilateral fractures of the pelvis and the femur--floating hip? A retrospective analysis of 42 cases. Arch Orthop Trauma Surg 1999;119(3-4):179-82.
https//doi.org/10.1007/s004020050385
15. Ogura H, Tanaka H, Koh T, Hashiguchi N, Kuwagata Y, Hosotsubo H, et al. Priming, second-hit priming, and
apoptosis in leukocytes from trauma patients. J Trauma 1999;46(5):774-81; discussion 781-3.
https://doi.org/10.1097/00005373-199905000-00004
16. Christensen MC, Banner C, Lefering R, Vallejo-Torres L, Morris S. Quality of life after severe trauma: results from the global trauma trial with recombinant Factor VII. J Trauma 2011;70(6):1524-31. https://doi.org/10.1097/TA.0b013e3181f053c2
17. Zamora-Navas P, Estades-Rubio FJ, Cano JR, Guerado E. Floating hip and associated injuries. Injury 2017;48(Suppl 6):S75-S80. https://doi.org/10.1016/S0020-1383(17)30798-2
18. Burd TA, Hughes MS, Anglen JO. The floating hip: complications and outcomes. J Trauma 2008;64(2):442-8.
https://doi.org/10.1097/TA.0b013e31815eba69
19. Iotov A, Tzachev N, Enchev D, Baltov A. Operative treatment of the floating hip. Orthopaedic Proceedings
2018;88(Suppl 1):160. Disponible en: https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.88BSUPP_I.0880160c