Floating Hip: Comparative Analysis of Outcomes and Associated Injuries

Keywords: Floating hip, associated injuries, high energy trauma, pelvis, acetabulum

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.

Downloads

Download data is not yet available.

Author Biographies

Enzo Emanuel Fuentes, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Santiago Svarzchtein, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Guillermo Ricciardi, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Alberto Cid Casteulani, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Rafael Amadei Enghelmayer , Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Mauro Chiodini, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Leonardo Giacobbe, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Sebastián Sasaki, Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina
Orthopedics and Traumatology Service, Centro Médico Integral Fitz Roy, Autonomous City of Buenos Aires, Argentina

References

Blake R, McBryde A Jr. The floating knee: Ipsilateral fractures of the tibia and femur. South Med J 1975;68(1):13-6. PMID: 807974

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

Liebergall M, Mosheiff R, Safran O, Peyser A, Segal D. The floating hip injury: patterns of injury. Injury

;33(8):717-22. https://doi.org/10.1016/s0020-1383(01)00204-2

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

Iotov A, Tzachev N, Enchev D, Baltov A. Operative treatment of the floating hip. Orthopaedic Proceedings

;88(Suppl 1):160. Disponible en: https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.88BSUPP_I.0880160c

Published
2022-04-18
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