Traumatic Hip Dislocation in A Child Younger Than 3 Years- A rare Case Report And Review of Literature.

Abstract

Introduction:Hip dislocation in a child less than 3 years is a very rare event. Only a few case reports have been documented in Western literature. It is rarely reported from Indian population. Hip dislocations are mostly due to low velocity injury in children younger than 3 years. We report such a case of hip dislocation in a 2 year old child.Case Report:A 25 month old child presented to our casualty following a fall from a slide 3 hours prior to presentation. His right lower limb was adducted and internally rotated. There was severe pain on attempting movements. An X-ray of the pelvis was taken which showed a posterior hip dislocation on the right side. The child had an emergency closed reduction under general anaesthesia followed by a broom stick plaster cast with hips in 30° abduction. Congruency of reduction was checked with image intensifier before plaster application. The plaster was removed at 6 weeks and gradual weight bearing started. The child was reviewed at 6 and 18 months with MRI scans at 6 and 18 months. There were no signs of avascular necrosis or chondrolysis.Conclusion:Paediatric hip dislocation (less than 3 years of age) is a very rare entity whose incidence is on the rise due to the increase in road traffic accidents. The key stone in proper management is clinical suspicion, early recognition and promptreduction (within 6 hours). Also gentle manipulation during reduction has a definite role in preventing iatrogenic chondrolysis and osteonecrosis of femoral head.