MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure

Mayer, Stephanie W.; Stewart, Jaime R.; Fadell, Michael; Kestel, Lauryn; Novais, Eduardo N.

doi:10.1007/s00247-015-3317-9

Cited by 26 publications

(27 citation statements)

References 18 publications

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“…In a series of 40 patients under 16 years old, Mayer et al reported that all surgically confirmed soft-tissue injuries were preoperatively identified on MRI, which also offered the advantage of absence of radiation in that age group. 13 CT scan may especially lead to underestimation of an osteochondral lesion at the posterior wall. 13 14 In the present case, a tear at the posterior labral complex, which lead to complete enfoldment of the posterior labrum, and an additional osteochondral fragment resulted in the nonconcentric joint after closed reduction of the hip.…”

Section: Discussionmentioning

confidence: 99%

“… 13 CT scan may especially lead to underestimation of an osteochondral lesion at the posterior wall. 13 14 In the present case, a tear at the posterior labral complex, which lead to complete enfoldment of the posterior labrum, and an additional osteochondral fragment resulted in the nonconcentric joint after closed reduction of the hip. Similarly, treatment of an incarcerated acetabular labrum following reduction of a traumatic hip dislocation has been effectively reported with either refixation or excision of an osseo-labral fragment via hip arthroscopy in adults.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Treatment of a Posterior Labral Interposition after a Pediatric Hip Dislocation—A Case Report

Kruppa

Dudda

Schildhauer

et al. 2018

European J Pediatr Surg Rep

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We report the case of a 13-year-old boy, who suffered a posterior hip dislocation from playing soccer. Closed reduction was performed urgently. Because of a nonconcentric hip after closed reduction, further imaging was done. An intra-articular bony fragment was identified. Arthroscopic treatment was performed. Through an anterior portal we were able to locate the intra-articular bony fragment, which was located within the region of the fovea. After lifting of the caudal enfolded labral complex, we were able to remove the fragment. Evidence of a grade 3 cartilage defect was present at the femoral head. We were able to reduce the enfolded posterior labral complex, which was stable afterwards without the necessity of additional suture fixations. The concentric hip reduction was confirmed on an anteroposterior view of the hip postoperatively. The patient was instructed to toe tip weight-bearing for 6 weeks with limited range of motion to 60° of hip flexion. Eight weeks after surgery, he was free of pain and discomforts. From our experience, the arthroscopic intervention after pediatric hip dislocation associated with intra-articular bony fragments or posterior labral complex injuries, represents to be a preferred minimally invasive method in contrast to open surgical procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of a Posterior Labral Interposition after a Pediatric Hip Dislocation—A Case Report

Kruppa

Dudda

Schildhauer

et al. 2018

European J Pediatr Surg Rep

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“…kombinierte Frakturen tendenziell nicht mit der MRT abgeklärt worden waren. Gemäß Literatur kam die MRT bisher bei Azetabulumfrakturen nur in gesonderten Fällen wie ausgedehnten Weichteilschäden (Morell-Lavallée-Läsion) oder pädiatrischen/adoleszenten Verletzungen zum Einsatz [26,27]. Meist ist die Azetabulumfraktur komplex und macht eine operative Rekonstruktion der Gelenkfläche erforderlich.…”

Section: Frakturlokalisationunclassified

Magnetic Resonance Imaging in Pelvic Fractures – Part 1: Which Criteria Lead Us to Supplementary MRI Diagnostics?

et al. 2019

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Introduction Isolated pelvic fractures are relatively rare with an incidence of 3 – 6% of all fractures, but their incidence in polytraumatized individuals increases to 25%. The S3 guideline Polytrauma gives a clear recommendation for diagnostics by means of pelvic radiography (X-ray) and computed tomography (CT). A recommendation for the diagnosis by means of magnetic resonance tomography (MRI) especially in patients with low energetic/missing trauma does not currently exist. It is unclear on the basis of which criteria the MRI can be indicated in pelvic fractures. The aim of our study was therefore to retrospectively record indications for the indication of MRI in pelvic fractures – with adequate as well as inadequate trauma. Material and Methods In a retrospective clinical study, a total of 140 patients (median 68 years, range 15 – 97, 75 female, and 66 male) with a pelvic fracture were included in the study over a period of three years. Overall, the trauma mechanism revealed 73 adequate and 67 inadequate fractures. 31/140 patients had undergone MRI of the pelvis in addition to a CT/X-ray scan. The two subgroups “with MRI” and “without MRI” were analyzed with regard to the parameters “sex”, “age”, “adequacy of the trauma”, “fracture localization”, “duration of admission to imaging”, “type of therapy” and “duration to surgery” compared. Results It was shown that the MRI diagnosis was performed especially in female, elderly patients (81 years, range 19 – 94 years). Patients with inappropriate trauma have received MRI more frequently (74%) than patients with adequate trauma (26%). With regard to fracture localization no differences could be shown. The MRI was performed on a median 4 days after the CT examination. Regarding the decision “conservative” vs. “operationally” our two groups without and with MRT tended to differ not. Patients with MRI were operated on median 2 days later than patients who did not receive MRI. Conclusions Pelvic fracture MRI should be performed primarily in elderly female patients without adequate trauma. In patients with adequate trauma, MRI is of low value, especially as MRI diagnostics are performed with delay, resulting in later surgery.

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“…2,27 Magnetic resonance imaging (MRI) has been used to supplement CT scans; however, the cost effectiveness of MRI and its ability to identify small bony fragments are debated. 2,28 Postoperative Prosthetic Dislocation Assessment Dislocations after total hip replacement are usually a result of low-energy trauma; however, high-energy dislocations occur and require a more detailed secondary survey. Prosthetic dislocations are a time-sensitive medical emergency.…”

Section: Native Dislocation Assessmentmentioning

confidence: 99%

Dislocation of the Hip: A Review of Types, Causes, and Treatment

Dawson-Amoah

Raszewski

Duplantier

et al. 2018

TOJ

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MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure

Cited by 26 publications

References 18 publications

Arthroscopic Treatment of a Posterior Labral Interposition after a Pediatric Hip Dislocation—A Case Report

Arthroscopic Treatment of a Posterior Labral Interposition after a Pediatric Hip Dislocation—A Case Report

Magnetic Resonance Imaging in Pelvic Fractures – Part 1: Which Criteria Lead Us to Supplementary MRI Diagnostics?

Dislocation of the Hip: A Review of Types, Causes, and Treatment

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