A Rare Case of a Traumatic Posterior Hip Dislocation in a 3-Year-Old Boy: A Case Report and Review of the Literature.

Jan-Dierk Clausen,Marcel Winkelmann,Christian Krettek,Stephan Brand,Christian Macke,Philipp Mommsen

doi:10.1155/2020/7560392

Jan-Dierk Clausen, Marcel Winkelmann + Show 4 more

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https://doi.org/10.1155/2020/7560392

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Abstract

We present a rare case of neglected hip dislocation in a 3-year-old boy. Hip dislocations in childhood represent less than 6% of all injuries. The boy presented to the ED with ongoing hip pain after his leg got stuck in a carousel. The physical and radiologic examination revealed a posterior right hip dislocation. The closed reduction failed, so open reduction during surgery was performed. The postoperative protocol included 3 days of immobilization with early mobilization and pain-adapted weight bearing. No signs of femoral head malperfusion occurred 2 months after the injury. The patient did not complain of any limitations such as weight bearing problems or loss of range of motion. In comparison to adults, there are several specialties such as the fact that minor trauma can lead to hip dislocations due to the laxity of the ligaments, and due to the limited direct anamnestic options, neglected hip dislocations can occur. The treatment should focus on immediate proper reduction. The main complications after traumatic hip dislocation are avascular necrosis of the femoral head, redislocation, and early osteoarthritis.

Highlights

Hip dislocations in young children under 3 years of age are very rare
Due to the special anatomical situation with laxity of the ligaments, even minor trauma can cause a dislocation of the hip in young children [3]
A special group of patients is composed of children with neglected hip dislocations after minor trauma because the treating physician can be confronted with growth disturbances, muscular atrophy, and other complications

Summary

Introduction

Hip dislocations in young children under 3 years of age are very rare. Traumatic hip dislocations represent less than 6% of all traumatic injuries in children [1, 2]. Due to the special anatomical situation with laxity of the ligaments, even minor trauma can cause a dislocation of the hip in young children [3]. Just like in adult patients, posterior hip dislocations are much more common than anterior dislocations. A special group of patients is composed of children with neglected hip dislocations after minor trauma because the treating physician can be confronted with growth disturbances, muscular atrophy, and other complications. Most neglected hip dislocations are posterior dislocations [4]

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