scholarly journals Traumatic bilateral posterior hip dislocation in children. A 12 years follow up case report

2020 ◽  
Vol 8 (2) ◽  
pp. 213-216
Author(s):  
Ignacio Soto-Juárez ◽  
Ricardo Martínez-Pérez
Keyword(s):  
Skeletal Maturity ◽  
Case Reports ◽  
Hip Dislocation ◽  
Late Complications ◽  
Close Monitoring ◽  
Spica Cast ◽  
Traumatic Hip Dislocation ◽  
Skin Traction ◽  
Posterior Hip Dislocation

Background. Bilateral traumatic hip dislocation in children is a very rare orthopedic emergency. Few case reports are available in literature. Clinical case. A 4-year-old male child case with a trivial mechanism of injury is presented. Closed reduction in emergency department was achieved after 24 hours of injury, he was placed on Bucks skin traction for 4 days and during 4 weeks in a spica cast. There was not either clinical sign nor images of early or late complications during follow up until he reached skeletal maturity. Discussion. Hip dislocation in children is a rare emergency with an incidence of 0.8 cases per million per year, its treatment should not be delayed to minimize late complications such as osteonecrosis, recurrent dislocations, osteoarthritis, neurological lesions, coxa magna and heterotopic ossification. The reported incidence for hip osteonecrosis is 36.4% for late (6 hours) and 8.2% after early (6 hours) reduction. After 12 years of follow up no complication was found although the reduction was made 24 hours later. Conclusions. After immediate reduction a 4 to 6 weeks immobilization period is an effective treatment. Close monitoring to timely identify and treat any further complication is mandatory.

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

2017 ◽  
Vol 4 (10) ◽  
pp. 3511
Author(s):  
Paa Kwesi Baidoo ◽  
Boniface Adegah
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Delayed Diagnosis ◽  
Hip Dislocation ◽  
Traumatic Hip Dislocation ◽  
Left Posterior ◽  
Posterior Hip Dislocation

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.

Traumatic Hip Dislocation in Children Follow Up of 13 Cases

Orthopedics ◽  
1989 ◽  
Vol 12 (3) ◽  
pp. 375-378 ◽  
Author(s):  
Kjeld Hougaard ◽  
Per B Thomsen
Keyword(s):  
Hip Dislocation ◽  
Traumatic Hip Dislocation

scholarly journals Management of late-detected DDH in children under three years of age

2020 ◽  
Vol 1 (4) ◽  
pp. 55-63
Author(s):  
Terje Terjesen ◽  
Joachim Horn
Keyword(s):  
Closed Reduction ◽  
Hip Dysplasia ◽  
Skeletal Maturity ◽  
Pelvic Osteotomy ◽  
Radiological Outcome ◽  
Femoral Head Coverage ◽  
Spontaneous Improvement ◽  
Skin Traction ◽  
Dislocation Of The Hip

Aims When the present study was initiated, we changed the treatment for late-detected developmental dislocation of the hip (DDH) from several weeks of skin traction to markedly shorter traction time. The aim of this prospective study was to evaluate this change, with special emphasis on the rate of stable closed reduction according to patient age, the development of the acetabulum, and the outcome at skeletal maturity. Methods From 1996 to 2005, 49 children (52 hips) were treated for late-detected DDH. Their mean age was 13.3 months (3 to 33) at reduction. Prereduction skin traction was used for a mean of 11 days (0 to 27). Gentle closed reduction under general anaesthesia was attempted in all the hips. Concurrent pelvic osteotomy was not performed. The hips were evaluated at one, three and five years after reduction, at age eight to ten years, and at skeletal maturity. Mean age at the last follow-up was 15.7 years (13 to 21). Results Stable closed reduction was obtained in 36 hips (69%). Open reduction was more often necessary in patients ≥ 18 months of age at reduction (50%) compared with those under 18 months (24%). Residual hip dysplasia/subluxation occurred in 12 hips and was significantly associated with avascular necrosis (AVN) and with high acetabular index and low femoral head coverage the first years after reduction. Further surgery, mostly pelvic and femoral osteotomies to correct subluxation, was performed in eight hips (15%). The radiological outcome at skeletal maturity was satisfactory (Severin grades 1 or 2) in 43 hips (83%). Conclusions Gentle closed reduction can be attempted in children up to three years of age, but is likely to be less successful in children aged over 18 months. There is a marked trend to spontaneous improvement of the acetabulum after reduction, even in patients aged over 18 months and therefore simultaneous pelvic osteotomy is not always necessary.

scholarly journals Management of Recurrent Posterior Hip Dislocation in a Down Syndrome Patient with Dysplastic Hip Using Ganz Periacetabular Osteotomy: Follow Up After 4 Years

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
Ismail H. Dilogo ◽  
Jessica Fiolin
Keyword(s):  
Down Syndrome ◽  
Periacetabular Osteotomy ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Syndrome Patient ◽  
Down Syndrome Patient ◽  
Dysplastic Hip ◽  
Posterior Hip Dislocation

Recurrent hip dislocation in a Down Syndrome patient with dysplastic hip is a very challenging case to treat even for an expert orthopaedic hip surgeon. Least compliant patient and family, lowly educated with low socioeconomic status and the dysplastic hip forces limited option as a treatment. This is the first case world wide reporting 4 year follow up of dysplastic hip with Down Syndrome treated successfully with PAO technique. Methods: An eighteen years old female with history of Down Syndrome had multiple posterior hip dislocation episodes since 3 years prior. Several attempts of close reduction and hip spica applications were performed upon dislocation despite no successful retaining of reduction. Acetabular index of right hip were 550 and epiphyseal plate hasclosed. PatientwasperformedopenreductionusingSouthern-Mooreposteriorapproachand osteotomy of ischium, continued with capsulorrhaphy followed with Smith-Peterson anterior approach and osteotomy of superior ramus pubis and iliac bone. Then, derotation maneuver was performed under image intensifier to obtain adequate coveragefollowedwithbonegraftandfixationusing2cannulatedscrewandhipspica castapplication. Results: Within four years after surgery, the hip has never been dislocated again, patient could sit without pain and walk with full weight bearing although Harris Hip Score could not be performed due to Down Syndrome. Leg length discrepancy was negligible,fracture has fully united and acetabularin dex was300. Conclusions: Ganz periacetabular osteotomy, although a technically demanding surgery, is a preferable treatment in recurrent hip dislocation for Down Syndrome patient with good to excellent clinical and radiological ou tcome

scholarly journals A Rare Case of a Traumatic Posterior Hip Dislocation in a 3-Year-Old Boy: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jan-Dierk Clausen ◽  
Marcel Winkelmann ◽  
Christian Macke ◽  
Philipp Mommsen ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Femoral Head ◽  
Rare Case ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Early Mobilization ◽  
Minor Trauma ◽  
Review Of The Literature ◽  
Early Osteoarthritis ◽  
Traumatic Hip Dislocation ◽  
Posterior Hip Dislocation

We present a rare case of neglected hip dislocation in a 3-year-old boy. Hip dislocations in childhood represent less than 6% of all injuries. The boy presented to the ED with ongoing hip pain after his leg got stuck in a carousel. The physical and radiologic examination revealed a posterior right hip dislocation. The closed reduction failed, so open reduction during surgery was performed. The postoperative protocol included 3 days of immobilization with early mobilization and pain-adapted weight bearing. No signs of femoral head malperfusion occurred 2 months after the injury. The patient did not complain of any limitations such as weight bearing problems or loss of range of motion. In comparison to adults, there are several specialties such as the fact that minor trauma can lead to hip dislocations due to the laxity of the ligaments, and due to the limited direct anamnestic options, neglected hip dislocations can occur. The treatment should focus on immediate proper reduction. The main complications after traumatic hip dislocation are avascular necrosis of the femoral head, redislocation, and early osteoarthritis.

scholarly journals Management of late-detected DDH in children under three years of age

2020 ◽  
Vol 1 (4) ◽  
pp. 55-63 ◽  
Author(s):  
Terje Terjesen ◽  
Joachim Horn
Keyword(s):  
Closed Reduction ◽  
Hip Dysplasia ◽  
Skeletal Maturity ◽  
Pelvic Osteotomy ◽  
Radiological Outcome ◽  
Femoral Head Coverage ◽  
Spontaneous Improvement ◽  
Skin Traction ◽  
Dislocation Of The Hip

Aims When the present study was initiated, we changed the treatment for late-detected developmental dislocation of the hip (DDH) from several weeks of skin traction to markedly shorter traction time. The aim of this prospective study was to evaluate this change, with special emphasis on the rate of stable closed reduction according to patient age, the development of the acetabulum, and the outcome at skeletal maturity. Methods From 1996 to 2005, 49 children (52 hips) were treated for late-detected DDH. Their mean age was 13.3 months (3 to 33) at reduction. Prereduction skin traction was used for a mean of 11 days (0 to 27). Gentle closed reduction under general anaesthesia was attempted in all the hips. Concurrent pelvic osteotomy was not performed. The hips were evaluated at one, three and five years after reduction, at age eight to ten years, and at skeletal maturity. Mean age at the last follow-up was 15.7 years (13 to 21). Results Stable closed reduction was obtained in 36 hips (69%). Open reduction was more often necessary in patients ≥ 18 months of age at reduction (50%) compared with those under 18 months (24%). Residual hip dysplasia/subluxation occurred in 12 hips and was significantly associated with avascular necrosis (AVN) and with high acetabular index and low femoral head coverage the first years after reduction. Further surgery, mostly pelvic and femoral osteotomies to correct subluxation, was performed in eight hips (15%). The radiological outcome at skeletal maturity was satisfactory (Severin grades 1 or 2) in 43 hips (83%). Conclusions Gentle closed reduction can be attempted in children up to three years of age, but is likely to be less successful in children aged over 18 months. There is a marked trend to spontaneous improvement of the acetabulum after reduction, even in patients aged over 18 months and therefore simultaneous pelvic osteotomy is not always necessary.

scholarly journals Hip Arthroscopy for Incarcerated Acetabular Labrum following Reduction of Traumatic Hip Dislocation: Three Case Reports

Hip & Pelvis ◽  
2016 ◽  
Vol 28 (3) ◽  
pp. 164 ◽  
Author(s):  
Jung-Mo Hwang ◽  
Deuk-Soo Hwang ◽  
Woo-Yong Lee ◽  
Chang-Kyun Noh ◽  
Long Zheng
Keyword(s):  
Hip Arthroscopy ◽  
Case Reports ◽  
Hip Dislocation ◽  
Acetabular Labrum ◽  
Traumatic Hip Dislocation

scholarly journals Management of isolated shaft femur fractures by traction and single-leg spica cast in children

2017 ◽  
Vol 4 (7) ◽  
pp. 2294
Author(s):  
Indrajeet Kumar ◽  
Rahul Kumar ◽  
Laljee Choudhry
Keyword(s):  
Average Duration ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Shaft Fracture ◽  
X Rays ◽  
Spica Cast ◽  
Medical College ◽  
Femur Fractures ◽  
Skin Traction

Background: Objective of the study was to find out the advantages of traction and single-leg spica cast in treatment of isolated femoral shaft fracture in children. Study design was Descriptive and place of the study was Darbhanga Medical College and hospital, Laheriasarai, Darbhanga, Bihar, India.Methods: 24 patients, age below 10 years, with a mean age of 5.37 years range with closed isolated femoral shaft fractures were included in the Study. Patients having compound fractures and those with associated injuries were excluded from the study. Spica cast was applied under sedation after preliminary skin traction, however immediate spica was given in children less than 2 year and those who had less than 2 cm shortening on telescopy. Follow up was done in OPD after 1,4,8,12,24 weeks with check x-rays taken at every visit.Results: 24 children were included in the study, with a mean age of 5.37 years range (2 months to 10 years). Average duration of skin traction was 14.8 days range (0-21) days. Average duration of hospital stay was 16 days range (2-22) days. Average time for fracture union was 7.4 weeks range (4-12) weeks. At final follow-up, 2 patient had Limb -Length Discrepancy (LLD) of 1.5 cm, 2 had LLD of 1 cm, 4 had LLD of 0.5cm, while 18 children had no LLD. None of the patients had short legged gait. None of the patients needed cast removal for any cast related complication.Conclusions: Traction followed by spica cast is a safe and effective method for closed fracture shaft of femur with very low risk of complication and can be done in children in less than 10 years of age.

Posterior hip dislocation associated with concomitant ipsilateral femoral head and shaft fractures: an unusual combination of injuries

2021 ◽  
Vol 14 (8) ◽  
pp. e244453
Author(s):  
Deepak Chouhan ◽  
Prateek Behera ◽  
Mohammed Tahir Ansari ◽  
Vijay Kumar Digge
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Trauma Management ◽  
Femur Head ◽  
Basic Principles ◽  
Shaft Fractures ◽  
Unusual Combination ◽  
Posterior Hip Dislocation

The combination of posterior hip dislocation with an ipsilateral femoral head and shaft fractures is unusual. While cases of concomitant fractures of femoral head and shaft have been previously reported, the treatment of such injuries is challenging. Presence of an associated hip dislocation further complicates the matter. A timely diagnosis and treatment are crucial to have a good outcome.We are presenting the case of a 20-year-old man who sustained a traumatic posterior hip dislocation with ipsilateral femoral shaft and femur head fractures. After reducing the hip, we fixed the femoral shaft with a retrograde femur nail and the femoral head by the trochanteric flip approach in the same sitting. The patient returned to his pre-injury occupation after 4 months. He has been doing well until his last follow-up, 1 year after the surgery, thus emphasising the utility of following basic principles of trauma management in the management of unusual injuries.

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