- See:
Radiology of Hip:
- Pre Reduction Evaluation:
- frx-dislocation usually confirmed by a single AP x-ray;
- rule out: assoc acetabular, femoral head, or femoral neck frx;
- these must be recognized prior to reduction;
- femoral head: for assoc frx;
- acetabulum: presence, size, and location of fragments;
-
Judet View
- evaluate post. wall frx ( > 40% is
Unstable)
- injured side is elevated to 45 deg w/ pt supine, to
demonstrate posterior acetabular rim in profile;
- femoral neck: r/o non-displaced frx that might displace when
Closed Reduction is attempted;
- CT scan should be performed in all cases to identify intra articular
fragments or associated fractures such as femoral head fractures;
- CT would be indicated prior to reduction if radiographs show a
posterior wall frx ( > 40% implies
Unstable frx-dislocation);
- Post Reduction Evaluation:
- need to assess stability following either closed or open reduction;
- CT can assist in assessment of stability after reduction of posterior
dislocations of the hip;
- stability is inversely proportional to the size of the posterior
acetabular fragment;
- fragments involving < 25% of acetabular wall do not affect hip
stability, while those involving > 40% result in instability;
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Changes on magnetic resonance images after traumatic hip dislocation.
