Locked Central Fracture Dislocation of the Hip in a Child after Low-Energy Trauma (original) (raw)
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Traumatic hip dislocation in a child
Annals of Emergency Medicine, 1987
Traumatic dislocation of the hip joint is relatively uncommon in children. The trauma required to produce a dislocation can vary from minimal to severe, high-energy force. We report a case of posterior hip dislocation in a 9year-old boy who received relatively minor trauma to his leg but who did not seek medical attention for more than 24 hours. The child's hip was reduced without significant sequelae. Delay in reduction greatly increases the likelihood of later complications, including avascular necrosis of the femoral head.
Traumatic Hip Dislocation in Childhood: A Report of 26 Cases and a Review of the Literature
Acta Orthopaedica, 1979
Twenty-six cases of traumatic hip dislocation in children are presented. Although closed reduction was achieved in most instances, open procedures had to be employed in two cases of soft tissue interposition and in a patient with ipsilateral fracture of the femoral shaft. In 16 patients, with a followup averaging 14 years, the incidence of complications (avascular necrosis, coxa magna and arthrosis) was significant. Factors predisposing to abnormal results were delayed reduction and severe trauma. Neither the method of immobilization nor the interval without weight-bearing over 4 weeks were of influence. Principles of treatment are suggested.
Outcome of traumatic hip dislocation in children
Journal of Pediatric Orthopaedics B, 2013
We reviewed 13 patients without an underlying syndrome with traumatic hip dislocation between 3 and 10 years of age (mean 4.8 years) at the time of injury. The final reviews were between 1 and 11 years (mean 6 years). All children had posterior dislocation, except one, who had an anterior dislocation. Time taken from trauma to reduction was less than 6 h in three patients, 6 h to 1 day in two patients, 1 day to 3 weeks in seven patients, and 4 weeks in one. All of them underwent closed reduction, except two, who required open reduction through a posterior approach. All patients had excellent hip function and radiographic result on the basis of Garret classification, except for one with limping at 4 years after trauma. The patients treated with hip spica after reduction (10 patients) did not have recurrent dislocation whereas two out of three patients who were treated without postreduction hip spica developed recurrent dislocation. One out of 13 patients without an underlying syndrome and a 6-year-old patient with Down syndrome with neglected hip dislocation and radiological avascular necrosis at presentation recovered with congruent hip following a complete and maintained reduction. This case series suggested that closed reduction was possible for cases of neglected hip dislocation for up to 3 weeks. Open reduction through the posterior approach was safe in neglected irreducible posterior hip dislocation. Those hips that underwent complete reduction and were maintained reduced with hip spica had an excellent functional outcome even in the presence of avascular necrosis. This is a level IV study.
Traumatic Dislocation of the Hip in a Child Caused by Trivial Force for Age
Case Reports in Orthopedics, 2014
Traumatic hip dislocation in children has a relatively rare occurrence. There are some residual complications, such as avascular necrosis of the femoral head, growth disturbance caused by premature fusion, neurological injury, recurrent dislocation, and posttraumatic arthritis. There is no consensus in the literature about the period of non-weight bearing after reduction. A rare case of a 13-year-old boy of hip dislocation caused by trivial force for age is reported followed by review of the pediatric literatures with treatment recommendation.
Traumatic hip dislocations in children
JPMA. The Journal of the Pakistan Medical Association, 2010
To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +/- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dis...
European Journal of Orthopaedic Surgery & Traumatology
Traumatic bilateral asymmetric hip dislocation is an extremely uncommon injury and rarely seen in children. We report two such cases in adolescent females injured in separate accidents. One of these patients also suffered a left femoral shaft fracture, ipsilateral labral avulsion and contra-lateral acetabular fracture. We report our experience in the management of this complex injury pattern and review the pertinent literature on the subject. Keywords Traumatic asymmetric bilateral hip dislocation Luxation traumatique bilate´rale de hanche dans l'adolescence: deux cas cliniques avec revue de la littre´ature Re´sume´La luxation de hanche bilate´rale est une le´sion extreˆmement rare, spe´cialement chez l'enfant. Les auteurs en rapportent 2 observations. Dans l'un des cas il existait une fracture diaphysaire du fe´mur, une avulsion du labrum et une fracture ace´tabulaire controlate´rale. Le traitement de ces le´sions complexes est rapporte´.
Turkish Journal of Trauma and Emergency Surgery, 2014
BACKGROUND: Six acute traumatic hip dislocations in pediatric patients were retrospectively analyzed. Types of dislocations, associated lesions, treatment methods, complications, and clinical and radiological outcomes were reviewed. METHODS: Six child patients treated due to traumatic hip dislocation between 2007 and 2011 in our clinic were included in the study. While five of the patients were male, one was female; the average age was 8 years and 8 months. The mean follow-up was 25.2±10 months. There were posterior dislocations in five cases and transepiphyseal fractured dislocation in one case. Four cases were treated by closed reduction while two cases were treated with open reduction method. RESULTS: In the last control of the patients, asymmetric widening in the hip joint was found due to osteochondral fracture in one patient and coxa magna occurred in one patient. Avascular necrosis developed in one case with transepiphyseal fractured dislocation. Harris hip score evaluation was found excellent in five cases and bad in the case with fractured dislocation. CONCLUSION: Traumatic hip dislocation is a rare condition. It should be treated with preferably closed method as soon as possible. Repetitive reduction trials should be avoided. Open reduction should be performed to recognize accompanying lesions after advanced radiologic examinations such as computerized tomography and magnetic resonance imaging.
The Not-So-Merry-Go-Round: Traumatic Inferior-Anterior Hip Dislocation in a 9-Year-Old
Cureus
Merry-go-rounds are not as innocuous as they may seem. Pediatric hip anterior-inferior dislocations are very rare and can be associated with low-energy trauma. Prompt recognition of pediatric hip dislocations is vital, and this should be treated as a time-sensitive orthopedic emergency. Closed reduction within 6 hours minimizes the risk of avascular necrosis (AVN). We present a case of a 9-year-old boy with an inferioranterior hip dislocation following low energy trauma while playing on a merry-go-round. The patient was emergently brought to the theatre for closed reduction under general anesthesia within 6 hours. At his 12month follow-up, he has a full range of motion without any pain.
Recurrent traumatic hip dislocation in an 8-year-old boy
Trauma Case Reports, 2021
Pediatric traumatic hip dislocations (PTHD) are rare and represent around 5% of all pediatric dislocations. Associated bony or soft tissue injury can occur as often as 17%-25% of the time. We report a case of an 8-year-old boy presenting a posterior hip dislocation after a low-energy trauma, which was initially managed with closed reduction and bed rest for 1 week. Two days after hospital discharge, he suffered a recurrent posterior hip dislocation. He was now managed with 4 weeks of bed rest and lower limb skin traction followed by 1 week of no weight-bearing on crutches. With 6 months of follow-up, he is asymptomatic, walking autonomously, with complete and painless range of motion of the affected hip and no major radiographic changes. Pediatric traumatic hip dislocation is a rare and challenging injury that should be managed promptly. Currently, there is no protocol concerning treatment in the literature and its largely dependent of patient and parents' cooperation.