Stewart and Milford developed a grading system to classify traumatic fracture-dislocations of the hip. This can help identify patients who may require more aggressive management and who are at greater risk for complications.
Constant finding: dislocation of the hip joint
Acetabulum
Hip Socket
Femur
Grade
no fracture
stable after reduction
intact
I
insignificant chip fracture(s)
stable after reduction
intact
I
one or more large rim fractures
stable after reduction
intact
II
blast fracture and disintegration
unstable
intact
III
NA
NA
fracture of head and/or neck
IV
where:
• The entire leg may be torn off (disarticulated) through the hip joint (I have seen this with a motorcycle accident). Would this be a Grade V or VI?
• A "blast fracture" may indicate a burst fracture.
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