Neglected hip dislocation: an unusual presentation, its management and review of the literature

Sandeep Kumar,Anshul Dahuja,Rashmeet Kaur,M S Narula,Sangam Garg

doi:10.1007/s11751-017-0285-7

Sandeep Kumar, Anshul Dahuja + Show 3 more

Open Access

https://doi.org/10.1007/s11751-017-0285-7

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Abstract

Neglected traumatic posterior hip dislocation is not an uncommon condition seen in developing countries. Its treatment is fraught with great difficulties and controversies. Here we present a 31-year-old female patient presented to our hospital 2 years after sustaining an accident. She had gone through multiple treatments for her dislocated hip without any success. After arrival to our hospital, patient managed by constrained total hip replacement (THR). Her Harris hip score improved from 48 (preoperative) to 81 (postoperative). On follow-up she had a good range of movement of the hip with no pain, deformity and limb length discrepancy. Constrained THR provides promising results in neglected hip dislocation.

Highlights

Neglected traumatic dislocations of the hip are rare in adults
Various studies reported different methods for operative treatment of neglected fracture– dislocations including the use of a sub-trochanteric osteotomy, the Girdlestone procedure, hip arthrodesis, hemiarthroplasty and total hip replacement [4]
The results can be further altered by avascular necrosis of the femoral head which occurs in more than 50% of these cases

Summary

Introduction

Neglected traumatic dislocations of the hip are rare in adults. in developing countries, unreduced traumatic dislocations are not uncommon. A 31-year-old female sustained a fall while climbing a mountain, resulting in an injury of her left hip, causing pain and an inability to weight bear. She saw a local doctor, who diagnosed a dislocation of her hip and attempted a reduction, which failed, as the hip remained painful und unstable. Eighteen months after the initial injury, the patient saw another orthopedic surgeon, who attempted a closed reduction with skeletal traction. The hip remained unreduced despite 2 months of continued traction, and the treatment was discontinued due to pin track infection of the skeletal traction pin We saw this patient 2 years after the initial injury complaining of hip pain. Her functional status improved on every successive follow-up visit, and the HHS score improved from 48 (preoperatively) to 81

Discussion

Findings

Compliance with ethical standards