Evidence map›Paper›PMID 40327139›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Traumatic hip dislocations in children and adolescents: diagnostic challenges and the significance of MRI imaging-a multi-center study.

Mirjam Evi Braun, Francisco Fernandez Fernandez, Lena Riha, Hagen Schmal, Peter Schmittenbecher, Dorien Schneidmueller, Christoph Strüwind, Philipp Schwerk, Sebastian Reineke, Frank Traub and 13 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Mirjam Evi BraunPhilipps-Universität Marburg, Marburg, Germany. braunmir@staff.uni-marburg.de.
Francisco Fernandez FernandezPhilipps-Universität Marburg, Marburg, Germany.
Lena RihaUniversity of Tübingen, Tübingen, Germany.
Hagen SchmalDepartment of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert Ludwigs University Freiburg, Freiburg, Germany.
Peter SchmittenbecherDepartment of Pediatric Surgery, Städtisches Klinikum Karlsruhe, Moltkestr. 90, Karlsruhe, Germany.
Dorien SchneidmuellerDepartment of Pediatric Trauma Surgery and Pediatric Orthopaedics, BG Unfallklinik Murnau, Professor Küntscher Str. 8, Murnau, Germany.
Christoph StrüwindDepartment of Trauma Surgery, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany.
Philipp SchwerkDepartment of Pediatric Surgery, University Hospital Dresden-Technical University of Dresden, Fetscherstraße 74, Dresden, Germany.
Sebastian ReinekeClinic for Pediatric Surgery & Pediatric Urology and Center for Children With Severe Burn Injuries, Gesundheit Nordhessen Holding AG, Kassel, Germany.
Frank TraubDepartment of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Christoph IhleDepartment of Trauma and Reconstructive Surgery, Eberhard-Karls-University Tuebingen, BG Unfallklinik, Tuebingen, Germany.
Justus LieberDepartment of Pediatric Surgery and Pediatric, Urology University Children's Hospital, Hoppe-Seyler-Strasse 1, Tübingen, Germany.
Christina WackCenter for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Philipps-Universität Marburg, Baldingerstrasse, Marburg, Germany.
Hauke RütherClinic for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany.
Florian BaumannRegensburg University Medical Center, Franz-Josef-Straus-Allee 11, Regensburg, Germany.
Ingo MarziDepartment of Trauma Surgery and Orthopaedics, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt Am Main, Germany.
Lewin-Caspar BusseDepartment of Trauma Surgery and Orthopaedics, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt Am Main, Germany.
Ludger TüshausDepartment of Pediatric Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Germany.
Miriam AdrianClinic for Pediatric Surgery, Faculty of Heidelberg, University Hospital Mannheim, Mannheim, Germany.
Florian BergmannDepartment of Pediatric Surgery, Dr. Von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Lindwurmstrasse 4, Munich, Germany.
Alexander GrafDepartment of Trauma Medicine and Orthopaedics, Ortenau Klinikum Offenburg, Special Orthopaedic Surgery, Offenburg-Kehl, Germany.
Martin M KaiserDepartment of Pediatric Traumatology BG Trauma Center, University Hospital for Pediatric Traumatology and Pediatric Surgery Chief, Bergmannstrost Merseburger Str. 165, 06112, Halle (Saale), Germany.
Oliver LooseDepartment of Orthopaedics, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraumatic hip dislocations in children and adolescents are rare but can lead to severe outcomes like avascular necrosis. Delayed reductions, often due to overlooked dislocations in initial imaging, pose a major risk. The variability in symptoms and emergency care challenges early diagnosis. This multi-center study evaluates diagnostic approaches to enhance protocols for identifying traumatic hip dislocations in childhood.

methodsThis retrospective multi-center study included 76 patients (aged ≤ 17 years) with acute traumatic hip dislocations and open growth plates from 16 German hospitals. Patient data and imaging from 1979 to 2022 were analyzed, with statistical evaluation performed using SPSS under ethical guidelines.

resultsX-rays (single and biplanar views) were the primary diagnostic method, utilized in 85% of cases. Dislocations were missed in 12% (9 cases), primarily among children under eight years, with half of those under four. Delayed reductions (15.8%, n = 12) were linked to undetected dislocations in imaging in 9 cases. Conventional X-rays frequently missed dislocations, whereas MRI successfully identified all cases. Among the 76 patients, 54 (71%) had associated injuries, with 57.9% (n = 44) diagnosed exclusively via MRI.

conclusionTimely diagnosis of traumatic hip dislocations is crucial, as delays increase the risk of femoral head necrosis. An algorithmic approach is essential for young children, where dislocations may not be readily suspected. MRI is vital in the secondary diagnostic phase, providing superior visualization of associated injuries, including acetabular avulsions and soft tissue interpositions highlighting the need for integration of MRI into a unified diagnostic algorithm for children suspected of such injuries. LEVEL OF EVIDENCE: IV.

Indexed as

Hip DislocationMagnetic Resonance ImagingAdolescentChildChild, PreschoolDelayed DiagnosisFemaleGermanyHumansInfantMaleRadiographyRetrospective StudiesAvascular necrosisChildrenConcomitant injuriesDiagnostic algorithmsMRITraumatic hip dislocation

Identifiers

PMID40327139
PMCPMC12055902

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