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Floating hip in polytraumatized patients: complications, mechanism of injury, and surgical strategy

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A Correction to this article was published on 29 November 2021

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Abstract

Purpose

Floating hip fractures are severe and rare injuries with high complication rate and lack of standard management. The purpose of this retrospective study was to review the outcomes of a case series of polytraumatized patients with floating hip injuries, in order to describe the relationship between complication rate and floating hip injury type, the pathomechanism of injury, and the surgical treatment strategy.

Methods

Forty-five patients with floating hip injuries were analyzed. Complication rate, mechanism of injury, and surgical strategy (damage control orthopedics, stages of internal fixation) were recorded. Fractures were classified using the Mueller system for floating hips and AO/OTA system for the other fractures.

Results

Of the 45 patients with floating hip injuries, 23 (51.1%) developed complications. The results revealed that the complication rate was associated with the instability and type of the pelvic or acetabular fracture (61-C AO/OTA pelvic fracture [73.3%; p = 0.04], 62-B AO/OTA acetabular fracture [88.8%; p = 0.03]). Vertical shear (VS) pelvic fractures were related to middle-distal femoral fractures and lateral compression/anteroposterior compression (LC/APC) pelvic lesions were associated to proximal femoral fractures (p = 0.012).

Conclusions

Complications were associated with the severity and instability of the pelvic and acetabular type of fractures. The pathomechanism causing Mueller type B and C floating hip injuries was illustrated. A two-stage “femur first” surgical approach was the preferred one for definite internal fixation of fractures.

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Data availability

Data can be made available upon request.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Milan, Italy

    Marco Brioschi, Paolo Capitani & Dario Capitani

  2. Hip Department, Azienda Socio Sanitaria Territoriale Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy

    Filippo Randelli

Authors
  1. Marco Brioschi
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  2. Filippo Randelli
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  3. Paolo Capitani
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  4. Dario Capitani
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Contributions

MB and DC initiated the study and set up the design. MB collected and analyzed data. MB wrote the manuscript. FR, PC, and DC revised every version. All authors reviewed the final manuscript.

Corresponding author

Correspondence to Marco Brioschi.

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Ethics approval

All procedures performed were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Not applicable to this retrospective study.

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The authors and institutions have consented to publication.

Competing interests

The authors declare no competing interests.

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The original version of this article was revised. The names of all authors are inverted.

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Brioschi, M., Randelli, F., Capitani, P. et al. Floating hip in polytraumatized patients: complications, mechanism of injury, and surgical strategy. International Orthopaedics (SICOT) 46, 361–368 (2022). https://doi.org/10.1007/s00264-021-05262-4

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  • DOI: https://doi.org/10.1007/s00264-021-05262-4

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