Abstract
Asymmetric bilateral dislocations of the hips are rare injuries. Among the small number of reports in the literature, most have attributed the cause to high-velocity motor crashes. These dislocations are often seen to be associated with fractures of the proximal femur or the acetabulum. We present a case of a 45-year-old man with bilateral asymmetric dislocation of hips which were purely ligamentous in nature, without any fracture. He sustained his injuries due to a fall while getting on a moving bus. It was an unusual mechanism of injury as compared to the other cases of asymmetric hip dislocations reported in published studies. Both hips were reduced under general anaesthesia within three hours of the trauma. Skin traction and non-weight-bearing rehabilitation were continued for six weeks. After 35 months of followup, the patient remains asymptomatic. Early diagnosis and timely reduction of such dislocations under anaesthesia are necessary for prevention of complications.
Highlights
Hip dislocations are common occurrences following highvelocity trauma
Closed reduction of the joints was planned under general anaesthesia
Because of the violent trauma involved in these injuries, these dislocations are often associated with fractures of the acetabulum, head of femur, neck of femur, trochanter, and even shaft of femur [4, 5, 7]
Summary
Hip dislocations are common occurrences following highvelocity trauma. But simultaneous bilateral hip dislocations only constitute 1.25% of all hip dislocations [1]. Simultaneous one-side anterior and one-side posterior hip dislocations (asymmetric dislocation) are even less common [1]. A man of 45 years of age presented to our trauma centre after sustaining injuries to both hips due to a fall while trying to get on an accelerating bus from the rear entrance. He was under the influence of alcohol when he had the accident. The radiographs showed posterior dislocation of the left hip joint (Thompson and Epstein type I) and anterior dislocation of the right hip joint (Epstein type IIA, obturator type) [6]. No fracture could be seen on radiographs in proximal ends of either femur or either acetabulum (Figure 2)
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