Bilateral asymmetrical hip dislocation: a case report and literature review

Abstract

Background Asymmetrical bilateral dislocation of hip is dislocation of both hips in different directions, one hip dislocates anteriorly and the other one dislocates posteriorly. 90 percent of all hip dislocations are unilateral and posterior. Asymmetrical bilateral dislocations are very rare. there is no study comparing asymmetrical bilateral dislocation and unilateral dislocations in detail. AVN (Avascular necrosis) is the most important complication of hip dislocation and the time interval between injury and reduction is crucial to avoid avascular necrosis. Case presentation: We are reporting a case of asymmetrical bilateral dislocation of the hip in a 60 years old man after falling from 6 meters height. 4 hours after injury, the patient was transferred to the operation room, and the dislocation was close reduced Literature review: A literature review was done to compare sexual distribution, mechanism of dislocation, and associated fractures between patients with asymmetrical bilateral dislocation of hip (n = 103) and unilateral dislocation of hip (n = 105). The results revealed that the female to male ratio is almost the same in both groups, although most patients were male in our population (81%). Traffic accidents are the most common cause of dislocation. Nevertheless, the odds of this mechanism are about 2 times larger in patients with asymmetrical bilateral dislocation (OR = 0.46). Fractures were more common among patients with asymmetrical bilateral dislocation, and the most common associated fractures included: Acetabulum (52.8%), posterior edge (21.3%), femur neck (18.5%), femur head (3.7%), and pelvis (3.7%). Conclusion Associated fractures are more common among patients with asymmetrical bilateral hip dislocation so have higher risk for long-term complications.