Annika Steinmeier (Berlin / DE), Marcel Niemann (Berlin / DE), Tazio Maleitzke (Berlin / DE), Vera Jaecker (Berlin / DE), Ulrich Stöckle (Berlin / DE), Sven Märdian (Berlin / DE), Katharina Salmoukas (Berlin / DE)
Introduction:
Floating hip injuries involve both pelvic and ipsilateral femur fractures (Müller, 1999) and are typically caused by high-energy trauma such as traffic accidents or falls from height (Brioschi, 2021). Due to their complexity, effective perioperative management and treatment is essential. As these injuries are rare, no standardized treatment protocol exists. This study aims to analyze long-term outcome and identify factors influencing recovery and outcome.
Methods:
We retrospectively analyzed 30 patients treated for floating hip injuries at our center between 2012 and 2022. Clinical data (ISS, hospital/ICU stay, surgery duration) and radiological findings (X-ray, CT) were collected perioperatively and during a mean follow-up of 3 years. Clinical outcomes were assessed using PROMs, including the Oxford Hip Score, SF-12, and SMFA. Statistical analysis was performed using SPSS, with a significance threshold of p<0.05.
Results:
All patients sustained high-energy trauma, with a mean ISS of 35.77 ± 13.04. Falls from height were the most common injury mechanism (87%). All patients underwent early surgery following shock room management. The severity of the pelvic fracture correlated with the total duration of surgery (ϱ=0.513, p=0.04). Acetabular fractures were associated with longer surgeries (p=0.038) and higher osteoarthritis rates on follow-up (p=0.018). Lateral compression fractures, according to Young and Burgess, were commonly associated with proximal femur fractures. ISS correlated with the lenght of ICU stay (ϱ=0.461, p=0.01) and postoperative outcomes. Treatment type and sequence did not appear to influence these outcomes.
Conclusion:
Floating hip injuries are rare and complex, with pelvic and acetabular injury severity influencing recovery an outcome. The type and sequence of osteosynthetic treatment had no significant effect. However, the optimal management of severe concomitant injuries is crucial for perioperative and long-term recovery.
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