Abstract
Posterior hip dislocations are the most common luxation types of the hip joint and a well-known and well-described condition. However, we report a case of posterior hip luxation with a series of posttraumatic muscular disorders that were difficult to identify and have not been described previously in scientific literature. We performed clinical and radiological follow-up of an individual for a period of over 19 months post trauma. Informed consent for the anonymized publication of this case was received from the patient. The presented patient is a 20-year-old female, athletic individual in generally good health condition. Our patient suffered from a posterior hip dislocation after a skiing accident on an iced slope. Posttraumatic follow-up was performed owing to persistent moderate hip pain. The patient underwent several experts’ consultations as well as two MRI examinations at 2 months and 19 months after the skiing trauma. Both of the MRIs showed several ruptured parts of the periarticular musculature. At the second MRI, additional compensatory hypertrophy of the piriformis muscle was detected. This report clearly illustrates the importance of profound anatomical knowledge of the surrounding structures of the hip joint, especially as the high psychological strain on the patient could have been reduced by a swifter and appropriate diagnosis.
Highlights
Posterior hip dislocation is more common than anterior or central luxation injury and represents 75 to 93% of the patients with dislocations of the respective joint.[1,2]The mechanism of injury is a direct application of force on the flexed hip, which leads to internal rotation and adduction
Involvement of the ventral group of the external rotator group has to be suspected in the majority of patients suffering from posterior hip dislocation and was described by Laorr et al.[1] in 100% of the patients in a case series of 14 individuals with the respective type of injury mechanism
According to Dwyer AJ et al.[10] muscular injuries can especially be seen in severe types of hip dislocation (Thompson–Epstein classification Type IV, that is, acetabular fracture reaching the ground of the fossa). This explains the common injury of the capsular ligaments that are adjacent to the respective muscles and support the 3 of 5 birpublications.org/bjrcr dorsal stabilization of the hip joint
Summary
Posterior hip dislocation is more common than anterior or central luxation injury and represents 75 to 93% of the patients with dislocations of the respective joint.[1,2]The mechanism of injury is a direct application of force on the flexed hip, which leads to internal rotation and adduction. Consequences of hip dislocation typically include injuries of internal structures of the hip joint, proximal fractures of the femur as well as lesions to periarticular soft tissue. Two months A few weeks later, our patient consulted her general practitioner and presented with continuing moderate pain in the right hip.
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