Posterior fracture dislocation of the hip joint: the value of the obturator-oblique view with the hip still dislocated.

Abstract

To determine the value of the Judet oblique views taken while the hip is still dislocated. Radiological review. Level I trauma center. In addition to the traditional views in fifty of 110 fracture-dislocations, Judet views were carried out with the hip still dislocated. Each of the respective views was viewed with the reviewer blinded to diagnosis and the fracture classified according to the information available on that view. The percent accuracy of each view was then calculated by comparing radiologic with intraoperative classification. Under the pretext that if any view enabled a more accurate classification of the fracture, it must be providing more information, we assessed the quantitative value of each radiologic view according to our ability to accurately classify the fracture. Using the CT scan alone, classification was accurate in 82 percent of cases because the CT often overdemonstrated the degree of comminution. When the added information available from the traditional radiographs was included, there was only a slight improvement (82 percent versus 84 percent). This was increased to 96 percent when the obturator-oblique dislocated view was included. Because it provides an uninterrupted view of the posterior wall, demonstrates the displacements of fragments, and provides a comparison for the reduced view, which greatly augments the available information, the obturator-oblique dislocated view should be done routinely in the assessment of all posterior fracture dislocations of the hip joint.