Neglected Traumatic Hip Dislocation in Children

Abstract

Traumatic dislocation of the hip in children is a rare injury. We report the outcome of open reduction of neglected traumatic posterior hip dislocation in 18 children. All patients had posterior dislocation and no associated fracture. They presented to the hospital because of persisting pain, deformity, and limp that were present for a mean period of 16 weeks after injury (range, 6-52 weeks). Open reduction was done in all patients because none of the hips could be reduced by skeletal traction in abduction. All of the hips had varying degrees of avascular necrosis (osteonecrosis), with preservation of joint space as seen on radiographs. At short term followup, seventeen children had an excellent functional outcome. We suggest that open reduction is a satisfactory treatment for neglected hip dislocation in children because an anatomically placed femoral head maintains the stimulus for growth of the pelvis and the femur. It prevents deformity and maintains limb length.