Traumatic Posterior Hip Dislocation Research Articles

Femoroacetabular Variations Are Predisposing Factors for Traumatic Posterior Hip Dislocation.

Although high-energy trauma mechanisms are generally considered to cause traumatic posterior hip dislocations, femoroacetabular variations are assumed to contribute to low-impact hip dislocations. Thus, the present study aimed to identify morphologic femoral and acetabular risk factors that may also contribute to posterior hip dislocations in high-energy trauma mechanisms. The acetabular and femoral morphology of 83 hips with a traumatic posterior dislocation following a high-energy trauma mechanism were analyzed and matched to a control group of 83 patients who sustained high-energy trauma without a hip injury. The lateral center-edge angle, acetabular index, acetabular depth/width ratio, cranial and central acetabular version angles, and the anterior and posterior acetabular sector angles were measured on computed tomography to quantify femoroacetabular impingement (FAI) morphology, acetabular version, and coverage. The caput-collum-diaphyseal angle and the alpha angles in the coronal and axial planes were measured to detect cam-type FAI deformity. A receiver operating characteristic curve was utilized to determine threshold values for an increased risk of hip dislocation. Acetabular retroversion and posterior acetabular undercoverage were significantly increased in patients with hip dislocations compared with controls (p < 0.001). The central acetabular version angle and posterior acetabular sector angle that indicated an increased risk of hip dislocation were ≤9° and ≤90°, respectively. Cam-type FAI deformity and coxa valga were significantly increased in the dislocation group (p < 0.001). The anterolateral alpha angle that indicated an increased dislocation risk was ≥47°. Acetabular retroversion, posterior acetabular undercoverage, and cam-type FAI morphology may be risk factors contributing to traumatic posterior hip dislocation in high-energy trauma mechanisms. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Traumatic Posterior Hip Dislocation in a Child: When is an Anterior Open Reduction Indicated? A Case Report

Traumatic hip dislocations in children are uncommon, occurring in about 5% of all dislocations in children. Neglected hip dislocations are rarer and pose a serious threat to the normal development of the hip with complications of avascular necrosis and unstable gait. Open reduction is usually required, but the most appropriate surgical approach has not been clearly defined. We reported a child with a traumatic posterior hip dislocation who was successfully treated through an anterior approach after a previously failed posterior open reduction. An anterior open reduction of the hip following a previous failed posterior open reduction is a safe procedure and avoids the likelihood of an iatrogenic injury to the sciatic nerve. Pre-operative imaging with a CT scan or MRI is required in neglected cases to visualise intra-articular bone fragments, which can prevent a concentric reduction.

Posterior acetabular wall morphology is an independent risk factor that affects the occurrence of acetabular wall fracture in patients with traumatic, posterior hip dislocation

PurposeSmaller posterior acetabular walls have been shown to independently influence the risk for bipolar hip dislocation. We asked whether differences would also be observed in patients with traumatic posterior hip dislocation with and without posterior wall fractures.MethodsBetween 2012 and 2020 we observed 67 traumatic posterior hip dislocations. Of these, 43 traumatic posterior hip dislocations in 41 patients met the inclusion criteria. Eighteen dislocations were excluded with an acetabular fracture other than posterior wall fracture and six dislocations had insufficient computed tomography (CT) data. The mean age was 41 ± 11 years, 32 males and nine females. We observed 26 traumatic hip dislocations with posterior wall fractures and 17 without. All patients underwent polytrauma CT scans and postoperative/postinterventional pelvic CT scans. On axial CT-scans, posterior wall determining angles were measured.ResultsPatients with posterior wall fractures were not significantly older than patients without posterior wall fractures (42 ± 12 vs. 38 ± 10 years; p = 0.17). Patients without posterior wall fractures had significantly smaller posterior acetabular sector angles (84° ± 10°) than did patients with posterior wall fractures (105° ± 12°) (p < 0.01; OR 1.178). Likewise, the posterior wall angle was significantly smaller in patients without posterior wall fracture (62° ± 9°) than in those with posterior wall fractures (71° ± 8°) (p < 0.01; OR 1.141).ConclusionBoth posterior acetabular sector angle and posterior wall angle are independent factors determining the posterior wall fracture morphology in patients with traumatic posterior hip dislocation. Age and the observed trauma mechanism did not differentiate between traumatic posterior hip dislocations with and without posterior wall fractures.

A Rare Case : Traumatic Posterior Hip Dislocation Associated with Anterior Column and Incomplete Posterior Column Acetabular Fracture

Introduction: The hip is among the most solid joints within the human body that took a lot of force to dislocate it. Hip dislocation is frequently associated with acetabulum fracture. Although traumatic posterior hip dislocation is rarely involved anterior column fracture. Case Presentation: We describe a rare case of traumatic posterior dislocation of hip associated with anterior column and incomplete posterior column acetabular fracture in a young female following road traffic accident. The patient hip dislocation was reduced with closed reduction and perfomed open reduction and fixation under C-Arm for acetabular fracture management. Assessment of anterior and posterior acetabular column was revealed stable after fixation. The goals are to maximize the patient's ability to function, enable early recovery to function. The patient was able to flex her left hip at 6 weeks after the surgery. Conclusion: This case highlights a rare case of the traumatic posterior hip dislocation associated with anterior column and incomplete posterior column acetabular fracture, attempts to elucidate the mechanism of injury and perform prompt reduction to achieve a better patient outcome.

A Rare Case : Traumatic Posterior Hip Dislocation Associated with Anterior Column and Incomplete Posterior Column Acetabular Fracture

A Rare Case : Traumatic Posterior Hip Dislocation Associated with Anterior Column and Incomplete Posterior Column Acetabular Fracture

Traumatic posterior dislocation of hip with ipsilateral fracture of shaft of the femur: external maneuvers reduction and osteosynthesis by screw plate about a case and review of literature at Tambacounda regional hospital in Senegal

&lt;p&gt;Traumatic hip dislocation associated with an ipsilateral femoral fracture is a rare injury. It occurs in a high-energy traumatic context. The classic mechanism consists of a fall with landing on the hip, which initially dislocates and the femur fracture occurs secondarily by adduction of the proximal fragment. The diagnosis is difficult in front of the fracture whose signs mask the vicious attitude of the dislocation. We reported the case of a passenger of a motorcycle who collided with a parked car. He was ejected from the motorcycle and landed on his right hip. We performed X-rays of hip and lower limb at his admission which revealed a dislocation of hip in its high posterior variety and a medio-diaphyseal fracture of femur on same side. Reduction of dislocation by external maneuvers was made and osteosynthesis of femur with screwed plate performed 48 h later. After 16 months of care, functional and radiological results sufficient.&lt;/p&gt;

Posterior Dislocation Of The Hip Joint Due To Trauma In Children: A Three-Case Series

Aim: To appraise cases that presented with posterior dislocation of the hip secondary to trauma in paediatric age group and to analyse difficulties along with challenges that arise in the diagnosis (both radiological and clinical), treatment plan, complications and the outcome of such injury in children. Methods: Three children with traumatic posterior hip dislocation and a mean age of 3.3±0.47 years who were followed-up at 6 months were assessed. Results: The primary early treatment was closed reduction, executed within six hours of injury. The three subjects were treated with reduction under anaesthesia. The adjuvant treatment was immobilization via hip spica. Follow up was uneventful. Conclusion: Dislocation of the hip joint due to trauma should be attended to as early as possible with emphasis on achieving anatomical reduction preferably via reduction and close follow up. Keywords: Hip joint, posterior dislocation, trauma

Avascular Necrosis of the Femoral Head After Recurrent Traumatic Posterior Hip Dislocation in a 10-Year-Old Girl: A Case Report

Background: Traumatic hip dislocation (THD) is a rare pathology in the pediatric population. The severity of the trauma, mismanagement, or late treatment of such pathology can lead to complications, including avascular necrosis (AVN) of the femoral head. We hereby report a case of recurrent traumatic posterior hip dislocation that eventually lead to AVN of the femoral head in a 10-year-old girl. Case presentation: A 10-year-old girl presented to the Emergency Department complaining of left hip pain one day following a fall from a standing position. On physical examination, the left hip was held in the position of flexion, adduction, and internal rotation, with complete loss of range of motion of the left hip joint. Radiographic imaging was done and showed: a posterior dislocation of the left hip, enlargement of the growth cartilage of the left femoral epiphysis, and hypertransparency of the anterosuperior corner of the left femoral neck, and increased bone density of the upper left femoral epiphysis, suggesting previous hip dislocations. Open reduction with arthrotomy and posterior capsulorrhaphy was performed 36 hours post-injury, followed by hip immobilization by a spica cast. Two months after surgery, the cast was removed. On examination, the left hip was stable with good mobility, and weight-bearing was authorized. Follow-up was done three months post-injury. The patient had no complaints, but radiographic images showed signs of avascular necrosis (AVN) on the left femoral head. Conclusion: Our case emphasizes the importance of early diagnosis and management of a THD in pediatrics, to prevent serious complications such as AVN.

Cementless Hip Arthroplasty in Patients with Subchondral Insufficiency Fracture of the Femoral Head.

Subchondral insufficiency fracture of the femoral head (SIFFH) occurs in elderly patients and might be confused with osteonecrosis of the femoral head (ONFH). Subchondral insufficiency fracture of the femoral head is an insufficiency fracture at the dome of the femoral head and has been known to be associated with osteoporosis, hip dysplasia, and posterior pelvic tilt. This study's aims were to evaluate (1) surgical complications, (2) radiological changes, (3) clinical results, and (4) survivorship of THA in patients with SIFFH. From November 2010 to June 2017, 21 patients (23 hips); 5 men (5 hips) and 16 women (18 hips) underwent cementless THA due to SIFFH at our institution. Their mean age was 71.9 years (range, 57 to 86) at the time of surgery, and mean T-score was -2.2 (range, -4.2 to 0.2). The mean lateral center-edge angle, abduction, and anteversion of the acetabulum were 29.9° (range, 14.8° to 47.5°), 38.5° (range, 31° to 45°), and 20.0° (range, 12° to 25°), respectively. The mean pelvic incidence, lumbar kyphotic angle and posterior pelvic tilt were 56.4° (range, 39° to 79°), 14.7° (range, -34° to 43°), and 13.0° (range, 3° to 34°), respectively. An intraoperative calcar crack occurred in 1 hip. The mean anteversion and abduction of cup were 29.0° (range, 17° to 43°) and 43.3° (range, 37° to 50°), respectively. One patient sustained a traumatic posterior hip dislocation 2 weeks after the procedure, and was treated with open reduction. At a mean follow-up of 35.4 months (range, 24 to 79 months), no hip had prosthetic loosening or focal osteolysis. At the latest follow-up, the mean modified Harris hip score was 79.1 (range, 60 to 100) points, and mean UCLA activity score was 4.2 (range, 2 to 7) points. The survivorship was 95.7% (95% CI, 94.9% to 100%) at 6 years. Cementless THA is a favorable treatment option for SIFFH in elderly patients. 3.

Traumatic Hip Dislocation in an NCAA DI Football Player with Occult Sequelae: A Case Report.

Background and PurposeAmerican football generates the most sports-related injuries in the United States, with tackling as the leading injury mechanism. Overall injury rate at the collegiate level has been reported as 8.61 per 1,000 athlete exposures (AEs) – twice the rate of high school levels; competition injury rates are reported as high as 36.94/1000 AEs. Traumatic hip dislocation is an uncommon injury typically arising from high-energy axial impact with only 2-5.5% occurring during sports activities.Case DescriptionA 22-year-old NCAA Division I football defensive back who experienced extreme left hip pain following contact with another player with his hip flexed during a game was diagnosed with a type 1 posterior hip dislocation, a grade 1 medial collateral ligament sprain with concomitant posterior thigh and hip muscle strains. Key impairments were limited left lower extremity motor performance, range of motion deficits, left hip pain, and diminished function and weight-bearing ability.OutcomesThe athlete reintegrated into typical defensive back off-season training approximately four to five months post injury without restrictions, however presented with new anterior hip pain seven months post injury revealing occult sequelae requiring surgical intervention. He was able to return to full play the following football season.DiscussionThis case report describes the successful return to sport of a Division I football player who sustained a traumatic posterior hip dislocation and complicated course including surgical intervention secondary to associated sequelae.Level of Evidence5

Arthroscopic Treatment of Acetabular Rim Fracture after Traumatic Posterior Hip Dislocation: A Case Series Study.

ObjectiveTo investigate the clinical and radiographic short‐term results of arthroscopic treatment for posterior labrum tears with an attached bony fragment after traumatic posterior hip dislocation.MethodsBetween July 2014 and May 2019, a consecutive series of nine patients diagnosed with a posterior labrum tear with an attached bony fragment after traumatic posterior hip dislocation were treated by hip arthroscopic techniques. The patients had been injured in traffic accidents (n = 6) or high falls (n = 3). All patients were provided primary treatment at the emergency department of our institution, and then were transferred to our department for arthroscopy. Demographic data (e.g. gender, age, etc), intraoperative findings, the preoperative and postoperative multiple clinical scores and radiological results were subsequently assessed. Visual analogue scale for pain (VAS) and modified Harris hip scores (mHHSs) were measured and compared before surgery, and at the last follow‐up.ResultsA total of nine patients were enrolled, all of them were male, with a mean age at surgery of 32.2 ± 5.6 years (range, 22–65 years). The patients were followed‐up for an average of 26.5 ± 4.1 (range, 24 to 50 years). During the arthroscopic surgery, all patients had labral tears with posterior acetabular rim fracture. All patients had loose osteochondral fragments. Five had partial or complete tears of ligamentum teres. Two patients had osteochondral damage. Two had capsular rupture. Postoperative X‐ray films and three dimension computed tomography (3D‐CT) showed satisfactory reduction of posterior acetabular wall fractures. The mHHS before surgery and at 1 year and 2 years after surgery were 51.8 ± 4.3, 81.8 ± 2.0 and 87.5 ± 1.9 respectively; VAS scores were 5.6 ± 0.5, 1.3 ± 0.3 and 0.7 ± 0.3 respectively. As compared with the condition before surgery, there was a significant improvement in the mHHS and VAS scores at 1 year and 2 years after surgery (P < 0.01). There was no significant improvement in the mHHS and VAS scores between 1 year and 2 years after surgery (P < 0.05). At the final follow‐up, all patients had regained full range of motion (ROM) and were satisfied with the results. None of the patients showed signs of heterotopic ossification, avascular necrosis or progression of osteoarthritis of the hip joint.ConclusionTraumatic dislocation is accompanied by a variety of intra‐articular hip joint pathologies. Managing posterior acetabular rim fracture after traumatic posterior hip dislocation using arthroscopic reduction and fixation with anchors is a safe and minimally invasive option and delays the progression of traumatic osteoarthritis.

The Importance of Allis Maneuver in the Management of Traumatic Posterior Hip Dislocation in Children: A Report of Two Cases

The Importance of Allis Maneuver in the Management of Traumatic Posterior Hip Dislocation in Children: A Report of Two Cases

Avascular necrosis of the femoral head after traumatic posterior hip dislocation with and without acetabular fracture.

Traumatic hip dislocation can be isolated or associated with acetabular fracture. Both injuries require emergency reduction of the dislocated hip. Avascular necrosis of the femoral head (AVN) is a potential complication that accompanies these severe injuries. Our objective is to identify the risk factors that cause AVN. We retrospectively analyzed 44 patients with traumatic hip dislocations (Group A) and patients with posterior fracture-dislocation of the acetabulum (Group B). The average follow-up was 5.38years in Group A, 5.59years in Group B. We used the Thompson-Epstein classification for hip dislocation and the Harris Hip Score (HHS) for evaluating final outcomes. In Group A, we analyzed 21 patients with isolated posterior hip dislocation. We had one (4.76%) case of AVN. In Group B, we analyzed 23 patients with posterior acetabular fracture-dislocation. We had eight (34.78%) patients with AVN (p = 0.016, p < 0.05). With hip reduced 6-12h after injury, we had AVN in one (4.34%) patient, with reduction 12-24h, AVN was present in two (8.69%), while in hip reduction done after 24h of injury, AVN was present in five (21.73%) patients (p = 0.030, p < 0.05). An essential prerequisite for the prevention of AVN of the femoral head after hip dislocation is emergency hip reduction. In acetabular fracture-dislocation, emergency hip reduction, anatomical reduction of the acetabular fracture and early stable osteosynthesis are also important. Main factor affecting the development of AVN is late reduction of the hip.

Recurrent traumatic posterior dislocation of hip in a 5-year-old boy

Recurrent traumatic posterior dislocation of the hip is a rare entity in the paediatric age group. We report an exceptional case of a 5-year old boy who sustained a posterior dislocation of the right hip joint following recurrent trivial trauma while playing, three times in the past one and half year. On literature review, we found that only a few cases have been reported and the management options still remain controversial.

Neglected Traumatic Posterior Dislocation of Hip in Children: Report on 2 cases

Neglected traumatic dislocation of the hip is extremely rare in children and the preferred treatment may still be debatable. In literature definition of old or late dislocation is not clear. According to Garrett et al (1979) that patients who were not treated within 72 hours after injury were called as old unreduced dislocation of hip (1). The option of management of hip dislocation in children are closed and open reduction, subtrochanter osteotomy, arthrodesis, or leave as such and wait for adulthood for total hip replacement (2). Here we present 2 cases of neglected traumatic posterior dislocation management and their outcomes. First came to hospital 10 weeks after trauma, second case came 32 weeks after. First case was treated by closed reduction and percutaneous K-wiring while second was performed adductor tenotomy before open reduction and internal fixation by K wire through the femoral head into acetabulum. Hip spica was applied post operatively. The K wire was removed at 6 weeks. Patients were allowed to bear weight from gradual to full weight bearing after 6 weeks.Discussion:Traumatic hip dislocations are rare in children accounting for less than 5% of all pediatric dislocation (4). Large series has shown this injury 25 times, less common in children than adults (5). It is further rare to see neglected dislocation in pediatric age group. Various studies reported difference methods for management. The options are close and open reduction, sub trochantric osteotomy, arthrodesis, pelvis osteotomy or leave and wait for adulthood (2). According to some studies, close reduction is possible if dislocation is of a relatively short duration (2-4 weeks) (5). Closed reduction and skeletal traction with the limb in abduction has some good results in selected cases (6). Gupta and Shrevet reported good results with the use of heavy traction and sedation (7). Pai and Kumar in their study of eight patients with neglected posterior dislocation concluded that 66% of the patients with dislocation less than 1 year old can be reduced by traction and abduction (3). In our cases, pre-reduction traction had been used temporary with the believe that the traction would stretch the soft tissue that create excessive pressure on the femoral head, making operative intervention easier. Kumar and Jain (8, 9) in their study of 18 patients treated by open reduction after skeletal traction was unsuccessful. Despite varying degree of avascular necrosis, the reported excellent results in 17 patients. In children, traumatic hip dislocation may lead complication such as recurrent dislocation, sciatic nerve palsy, post traumatic degeneration arthritis, coxa magna and avascular necrosis (10, 11). Somehow among all complication, AVN has the worst prognosis (10, 11, 12). AVN usually develops in the first three years (10,11). AVN reaches up to 100% in neglected traumatic hip dislocation patient (13). Growth disturbances develops due to proximal physical damage and effects especially children under the age of 12 and it may lead to leg length discrepancy and angular deformity in femoral neck (14). Growth disturbance usually emerges as coxa magna in children older than 12 years. Coxa magna was also encountered in our case. The resultant coxa magna seen on radiographs here not caused hip symptom years after but predispose hip to secondary osteoarthritis.Conclusion:Intra-articular normal saline (IA-NS) injections have been utilized as a placebo in a number of researches pertaining to the management of joints problem such as knee osteoarthritis (OA). It is believed that these IA-NS injections may have a therapeutic effect that has not been quantified in the literature. Lidocaine have some mild anti-inflammatory effect during its relatively short halflife of 1.5 hours. The prompt effect of the local anesthetic providing temporary relief of symptoms can help confirm proper placement of the injection and support that the site injected was the source of the pain.Conclusion:Neglected traumatic posterior dislocation of the hip can be treated with closed reduction or open reduction. Repetitive closed reduction trial should be avoided. It should be kept in mind that the rate of avascular necrosis may reach up to 100%.

Traumatic dislocations of the hip in children About 11 cases and literature review

Traumatic dislocation of the hip in childhood is rare. Several small series of this condition have been published. The objective of this study was to evaluate the outcome of treatment of traumatic posterior hip dislocation in children. Data from 11 children (11 hips) with traumatic hip dislocation, collected in 2 centres (2 countries), from January 2010 to January 2019 were analysed. The clinical assessment focused on symptoms and physical findings. X-rays identified the type of hip dislocation. Hip dislocations were classified according to Thompson and Epstein. Reduction was performed using three techniques: technique 1, closed reduction. Technique 2, release of the long adductor muscle, lengthening of the psoas tendon, and placement of a Kirschner wire through the femoral head into the acetabulum. Technique 3, open reduction after hip arthrolysis. X-rays were then used to determine whether the hip is concentric and to check for any other injuries that may have occurred after manipulation. There were 3 girls (27.3%) and 8 boys (72.7%) in this study.

Transfer of osteochondral shell autografts to salvage femoral head impaction injuries in hip trauma patients

IntroductionFemoral head impaction defects are observed with variable severity, as a result of traumatic hip dislocations which can be caused by traffic accidents or seen in professional athletes amongst other mechanisms. Compression of the articular cartilage and the subchondral bone into the femoral head results in irregular articular surfaces influencing the outcome with predisposition to osteoarthritis, and being predictive for the need for delayed total hip replacement. This study reports the outcome after a minimum follow-up (FU) of five years in a consecutive series treated with transfer of osteochondral shell autografts in hips (TOSAH) from the head-neck junction into the defect using surgical hip dislocation. Patients and methodsBetween 06/2007 and 03/2014 a series of twelve consecutive patients (mean age: 35yrs, range 18–53; median Injury Severity Score: 12, range 9–27) sustained a traumatic posterior hip dislocation in combination with acetabular and/or Pipkin fractures and were inter alia treated using TOSAH using surgical hip dislocation. Conversion to total hip replacement (THR) during FU was noted as failure. Patients were clinically (Merle d'Aubigné score) and radiographically assessed for occurrence of osteoarthritis (OA), avascular necrosis (AVN) and/or heterotopic ossification (HO) at a minimal follow-up of five years. ResultsMean follow-up was 6.9 years (5.0–11.6). At five-year follow-up, we found a survivorship of 57.1% (95% Confidence interval {CI}, 46.7–100%). Four patients required conversion to a total hip replacement at 11, 16, 28 and 44 months respectively after the TOSAH procedure due to osteoarthritis progression. One patient required conversion to a total hip replacement 12 months after TOSAH procedure due to AVN. One patient was lost to follow-up after 2.7 years. The remaining six patients with preserved hips presented with a median Merle-d'Aubigné score of 16 points (range: 14–18) and no AVN. Two patients showed asymptomatic grade I osteoarthritis according to Tönnis at latest follow-up and three patients showed mild asymptomatic HO according to Brooker (Grade I-II). ConclusionThe presented technique can be used as a salvage procedure for severely injured hip joints and to preserve the hip joint at midterm with satisfying clinical and radiological outcomes.

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques.

Background and Purpose Hip dislocation combined with acetabular fracture remains a challenging condition for orthopedic surgeons. In this study, we utilized a computer-assisted simulation and three-dimensional (3D) printing technology to treat patients with hip dislocation combined with acetabular fracture. We hypothesized that the 3D printing-assisted method would shorten the internal fixation time and surgical time. Methods We retrospectively reviewed 16 patients diagnosed with traumatic posterior dislocation of hip combined with acetabular fractures and treated with plate fixation from September 2013 to August 2017. Patients were divided into two groups: (1) traditional method and (2) 3D printing groups. In the traditional method group, the plates were contoured during the surgery, whereas in the 3D printing group, the patient's pelvic computed tomography image was transformed to the 3D medical image software for processing preoperatively. The fracture reduction was simulated by the computer. Thereafter, the 1:1 scale 3D printing model was used to design the surgical plan and contour patient-specific plates preoperatively. Results The internal fixation time was significantly shorter in the 3D printing group than in the traditional method group (-33 min, P<0.05). The mean operative time was shorter than that in the traditional method group (-43 min). However, blood loss and postoperative radiograph results were similar between the groups. The complication rate was lower in the 3D printing group (2/7) than in the traditional method group (5/9). Interpretation Computer-assisted simulation with 3D printing technology is a more efficient method for treating hip dislocation combined with acetabular fractures.

Delayed diagnosis of traumatic posterior hip dislocation in a 6-year-old girl with 6 years follow up: a case report

Though uncommon, cases of traumatic hip dislocation have been reported in children worldwide. Averagely, it is recommended that the acceptable duration for reduction after such dislocations is about 6 hours. Even with that there is about 5% documented chance of developing avascular necrosis of the head of the femur. The incidence of avascular necrosis increases with delayed relocation of the femoral head. We report a case involving a 6-year-old girl with a 2-week delayed diagnosis of a left posterior hip dislocation that was reduced and followed up for 6 years.

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

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.