Best Practice Case Studies-Posterior Hip Dislocation

Pdf Summary

This case report discusses a rare incident of traumatic posterior hip dislocation in a 3-year-old boy, an injury that constitutes less than 6% of all childhood injuries. The boy experienced hip pain after getting his leg stuck in a carousel, resulting in a posterior right hip dislocation. Initial attempts at closed reduction failed, necessitating an open reduction surgery. Post-surgery, the boy was immobilized for three days, followed by early mobilization and pain-adapted weight bearing. Two months post-injury, the boy showed no signs of femoral head malperfusion or limitations, such as weight-bearing issues or loss of motion range.<br /><br />Children under the age of three are particularly susceptible to hip dislocations due to ligament laxity, and minor trauma can easily lead to dislocations. Complications commonly associated with traumatic hip dislocations include avascular necrosis of the femoral head, redislocation, and early onset osteoarthritis. Early and proper reduction of the dislocation is crucial, with higher risks of necrosis occurring when treatment is delayed beyond six hours post-injury.<br /><br />In this case, an MRI revealed associated soft tissue damages, including a ruptured ligament of the femoral head, which prevented proper closed reduction. Open reduction was then conducted using the Kocher-Langenbeck approach, and subsequent checks showed no malperfusion of the femoral head. The literature underscores the importance of immediate reduction and appropriate imaging, favoring MRI due to its higher diagnostic value and lower radiation exposure compared to CT scans. Overall, although traumatic hip dislocations in young children are rare and potentially problematic, immediate and appropriate treatment typically results in successful outcomes without long-term consequences.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 23

Topic Hip

Keywords

2nd Edition, CASE 23

2nd Edition

Hip

traumatic posterior hip dislocation

3-year-old boy

open reduction surgery

femoral head malperfusion

ligament laxity

avascular necrosis

Kocher-Langenbeck approach

MRI diagnostic value

early mobilization

childhood injuries