Epstein HC. Wiss DA. Cozen L. Clinical Orthopaedics & Related Research. (201):9-17, 1985 Dec. In general, all traumatic dislocations of the hip must be treated as surgical emergencies. Multiple attempts at closed reduction are contraindicated, particularly in Type V dislocations. Every effort must be made to recognize the dislocation, particularly in patients with other severe lower extremity trauma. Reduction within 24 hours gives better results than late reductions. Roentgenograms of the pelvis must include Á both hips after closed or open procedures as a check for a concentric  reduction of the hip. Any abnormality, or failure to reduce the avulsed head fragment, demands an immediate hip arthrotomy. The good results, after primary open reduction, although under 50%, were better than closed or closed followed by open reduction. Our approach is to discard the avulsed head fragment. No conclusions can be made regarding screw fixation of the avulsed fragment because there was an insufficient follow-up period in this procedure. Long-term follow-up examination is necessary in Type V fracture dislocations because one can anticipate that arthritic changes will develop in more than 50% of patients. Anterior approaches to excise head fragments in Type V dislocations are contraindicated. Early intervention is indicated in al d`slocations with sciatic or peroneal nerve paral siq. Because most dislocations in this series w re due to
