No abstract

BACKGROUND Treatment of old, neglected, unreduced dislocation of hip is usually associated with lot of difficulties and requires complex reconstructive procedures. [1,2] Various options available are open reduction, [3] trochanteric osteotomies, [4] arthrodesis [5,6] and arthroplasty. [1,7] CASE REPORT Here we have a case of 45-year-old male with a 14-year-old unreduced neglected posterior dislocation of Lt. hip with 7 cm shortening and muscle wasting with Trendelenburg test, telescopy test positive, weakness in active abduction and flexion deformity. For which patient is initially treated with skeletal traction to stretch the muscles and soft tissues. Then staged procedure of release of contracted muscles and soft tissues in first sitting followed by skeletal traction for 3 weeks. Then total hip arthroplasty of Lt. Hip was done. DISCUSSION Post-operatively, patient was followed up and he obtained pain free, functional and stable range of movements to do all his activities of daily living without any hindrance. Total hip arthroplasty has the upper hand in treating very old, unreduced and neglected posterior dislocation hip (like in this case-14 years old dislocation!); because as per literature open reduction is not possible for dislocations > 3 months, as it finally leads to AVN and a painful and stiff joint. Also other procedures like subtrochanteric osteotomies lead to limping and limitation of range of the hip for most of the authors and arthrodesis leads to stable but fixed and immobile hip. CONCLUSION Total Hip Arthroplasty is a safe and acceptable procedure for very old, unreduced and neglected dislocation of hip providing a stable, pain free and mobile hip.