“FROG-LEGGED TRAUMA PATIENT”. BILATERAL ANTERIOR HIP DISLOCATION.

Abstract

Anterior hip dislocation is rare (10-15% occurrence) compared with posterior dislocation. Bilateral simultaneous anterior hip dislocation is even extremely rare. Most of the previously reported case were either a unilateral or combination of anterior and posterior dislocation. We present a case of bilateral anterior hip dislocation post motor vehicle accident. Patient brought in the Emergency Department in “frog-legged” posture, unable to straighten the lower limbs. Even the Pre-Hospital Care (PHC) team had a tough time to load the patient onto the ambulance stretcher. On examination, both lower limbs were held in abduction, external rotation and in flexion position. Neurovascular assessments were intact. Pelvic x-ray shows bilateral anterior hip dislocation, right iliac bone fracture and left greater trochanteric femur fracture. Closed manual reduction of both hip were performed under procedural sedation analgesia. CECT pelvic done later confirmed right iliac bone fracture extending to and comminuted fracture of the left greater trochanteric. Bilateral avascular necrosis of both femoral head was also noted. Traumatic hip dislocations are a true orthopedic emergency. Early reduction (within 6 hours) is required as soon as appropriate x-rays have been obtained to exclude associated injuries since avascular necrosis of the femoral head increases in direct proportion to delay in reduction. If this fails, closed reduction under general anesthesia is indicated.