[Post-traumatic coxarthrosis. Medicolegal conditions of the likelihood of fractures, luxations or contusions].
Trauma is the cause of 5 to 10% of all cases of osteoarthritis of the hip. One third of patients with a dislocation or fracture-dislocation of the hip or an acetabular fracture develop osteoarthritis of the hip within one to 20 years. Symptoms may be minor or absent during the interval. In addition to severe injuries, simple contusions resulting for instance from a blow to the greater trochanter or knee or from forced abduction of the hip (e.g., splits) can also result in osteoarthritis of the hip. We developed a set of five imputability criteria, of which three are essential: 1) documentation of the exact nature of the trauma; 2) absence of osteoarthritis in the uninjured hip; 3) consistency between the estimated duration of osteoarthritis and the date of the injury. Causality assessment problems which arise when a trauma worsens or accelerates preexisting osteoarthritis are discussed on the basis of clinical and roentgenographic findings. Mechanical and biochemical factors involved in the pathophysiology of contusion-related osteoarthritis of the hip are briefly reviewed.
Lequesne
M
M
Département de Rhumatologie, Hôpital Léopold-Bellan, Paris.
Azorin
M
M
Lamotte
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D003288:Contusions / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005554:Forensic Medicine; D005602:France; D006617:Hip Dislocation / Q000175:diagnosis*; D006620:Hip Fractures / Q000175:diagnosis*; D025981:Hip Injuries; D006801:Humans; D007603:Jurisprudence; D008297:Male; D015207:Osteoarthritis, Hip / Q000145:classification / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D015599:Trauma Severity Indices
La coxarthrose post-traumatique. Conditions médico-légales d'imputabilité à une fracture, une luxation ou une contusion.