Asymmetric bilateral traumatic hip dislocation: A case report

Abstract

IntroductionTraumatic hip dislocation is a severe injury with the potential for significant morbidity and mortality. Bilateral hip dislocation is rare representing 1.25% of all hip dislocations.Presentation of the caseA 19-year-old male had a high-speed motor vehicle accident. After stabilizing the patient, it was noticed that the position of the right lower limb was in adduction and internal rotation while the left was in external rotation and abduction. Pelvis x-ray showed right superior posterior and left anterior inferior hip dislocations. Closed reduction was performed within 3 hours from the trauma for both sides. The post reduction CT scan showed adequate reduction of both hips with no associated fractures. During his three-year follow-up, he never had any complaints and the clinical examination and radiographs did not reveal any abnormalities.DiscussionEarly reduction of hip dislocations minimizes the risk of osteonecrosis of the femoral head. The current recommendations state that a hip dislocation must be reduced within 6 hours.ConclusionThis is a rare case of bilateral asymmetric hip dislocations with no concomitant fractures. It is important to reduce hip dislocation within 6 hours from the time of injury to prevent osteonecrosis of the femoral head.

Bilateral asymmetrical hip dislocations with acetabulum fractures; a case report

“…10% patients with posterior hip dislocation associated with sciatic nerve injury (Peroneal part) with chance of recovery in between 60 and 70%. [ 13 ].…”

“… Dudkiewicz et al [ 4 ]; 2000 Right posterior Left anterior No associated injury Right reduced close Left open reduces through anterior approach 24 month follow up No Avascular necrosis – 5 Martinez A A, et al [ 5 ]; 2000 Right Anterior & left posterior Posterior coloumn Acetabulum Open undisplaced patella fracture Both reduced closed No AVN 20 months follow up Acetabulum fixed at 4 days 6 Alshamari A et al [ 12 ]; 2018 Right posterior & left anterior Right Pneumothorax (chest Tube) Both reduced close NO AVN Three yrs. follow up – 7 Kanojia RK et al [ 13 ]; 2013 Right anterior Left posterior No associated injury Both reduced closed no – …”

Simultaneous asymmetrical bilateral hip dislocations – A report of three cases with different presentations and management

“…The most common mode of injury resulting in a hip dislocation is a road traffic accident, in which a dashboard type of injury with forces directed proximally from the knee towards the hip along the femoral shaft produce a posterior dislocation of a flexed, adducted and internally rotated hip. 3,18 Anterior hip dislocations constitute around 11% of all hip dislocations and usually result when the hip is forced into abduction or adduction and external rotation. 3,18 Thus, one can readily appreciate that the position of the limb necessary to produce an anterior and a posterior dislocation is opposite for each type.…”

“…3,18 Anterior hip dislocations constitute around 11% of all hip dislocations and usually result when the hip is forced into abduction or adduction and external rotation. 3,18 Thus, one can readily appreciate that the position of the limb necessary to produce an anterior and a posterior dislocation is opposite for each type.…”

“…It is currently agreed that the risk of osteonecrosis after a hip dislocation is related to the length of the time the hip remains dislocated. 1,18 This risk rises after a delay of 6 h, or after repeated attempts at closed reduction. Overall, the risk of developing osteonecrosis of the femoral head after an anterior or posterior hip dislocation range from between 8% and 15%, to as high as 40% after operative treatment [2,312].…”