Treatment of Grade IV Fracture-Dislocation of the Hip

1. The best results in this series were achieved by prompt closed reduction followed by traction or immobilization. When this method of treatment was used, bone union of the fracture of the femoral head resulted. 2. In the remaining cases in this series, in which closed reduction could not be successfully done, a small percentage of good results was obtained by open reduction with or without internal fixation. 3. Open reduction after excision of a blocking or comminuted fragment usually resuited in a hip which could tolerate weight-bearing for several years. At present there is not sufficient data on which to base a prediction of the weight-bearing expectancy of such a hip. 4. Salvage procedures are indicated for hips in which there is irreparable immediate damage and for hips in which there is progressive degeneration. 5. The terminology of dislocation and fracture-dislocation of the hip continues confused, although modern English authors are in general accord 1,3,9,10,11. Future studies would be facilitated and an indexing of the literature would be simplified if a comprehensive classification of these injuries were established.