Ipsilateral Anterior Then Irreducible Posterior Hip Dislocation Without Fracture: A Case Report

Liporace, Frank A.; Dasti, Umer; Raiszadeh, Kian

doi:10.1097/bot.0b013e3181728436

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Isolated hip dislocations or dislocations with femoral head fracture generally result from high-energy trauma and are often accompanied by associated injuries. It may result from a passenger-motor vehicular crash, a pedestrian-motor vehicular injury, or industrial accidents 23456. It is also associated with certain sporting activities such as rugby, basketball, water skiing, gymnastics, race car driving, and equestrian sports 6789101112.…”

Section: Introductionmentioning

confidence: 99%

Traumatic hip dislocations in an orthopedic center in Lagos

Babalola¹,

Laiyemo²,

Audu³

et al. 2018

Niger Med J

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Background: Hip dislocations are one of the orthopedic emergencies. They may result from a high-energy transfer as in a road traffic crash. Prompt recognition and treatment can reduce the long-term morbidity associated with delayed reduction. The goal of this study was to evaluate the epidemiology and outcome of treatment. Patients and Methods: This was a retrospective study that involved cases of traumatic hip dislocations seen at the National Orthopedic Hospital, Lagos, Nigeria, between January 1, 2010 and June 30, 2014. Biodemographic characteristics, mechanism of injury, and type of dislocations were retrieved from case files. Thompson and Epstein type of the dislocated hips as well as the presence of pre- and post-reduction complications was noted. Results: Forty-five patients had hip dislocations in the study period. Only 27 had the relevant information to be included in the study. All cases were posterior hip dislocations. The median follow-up was 9 months (range 6–30 months). More dislocations occurred on the left [18 (67.0%)] than on the right [9 (33.0%)]. The median age of patients was 37 years (range 21–73 years). Twenty-six dislocations (96.3%) were due to road traffic crash and a case (3.7%) was due to an industrial accident. Grade IV Epstein was the most common injury recorded. Twenty-four (89.0%) cases were managed with closed reduction, whereas the remaining 3 (11.0%) cases had open reduction. The associated complications observed were sciatic nerve injury, avascular necrosis of the head of the femur, and protrusio acetabuli. Conclusion: Road traffic crash remains a leading cause of traumatic hip dislocation. Severity of injury and delay in reduction contributes to the complications of treatment.

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Section: Introductionmentioning

confidence: 99%

Traumatic hip dislocations in an orthopedic center in Lagos

Babalola¹,

Laiyemo²,

Audu³

et al. 2018

Niger Med J

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“…I rreducible hip dislocations occur rarely and are usually due to incarcerated intra-articular fragments in the case of posterior wall fractures or due to buttonholing from blocking soft-tissue structures [5][6][7][8] . Even more rarely, irreducible femoral head fracture-dislocations occur because of the displacement of the intact proximal femur through the posterior-superior labral bone interval.…”

Section: Discussionmentioning

confidence: 99%

“…ip dislocations are considered orthopaedic urgencies, and late reductions are associated with poor outcomes and an increased risk of avascular necrosis (AVN) [1][2][3][4] . Irreducible hip dislocations without fracture are usually obturator dislocations or anterior or posterior dislocations that are buttonholed through the capsule or blocked by other soft-tissue structures such as the piriformis [5][6][7][8] . Irreducible dislocations with fracture are usually posterior wall acetabulum fractures with incarcerated intra-articular fragments blocking reduction or femoral head (pipkin) fractures with posterosuperior displacement through a bony/labral injury onto the ilium 7,9 .…”

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confidence: 99%

Irreducible Traumatic Fracture-Dislocation of the Hip with Impalement onto the Ischial Spine

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2022

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Case: A 45-year-old man appeared to have a central (protrusio) hip dislocation but actually had a transverse posterior wall acetabulum fracture with irreducible posterior dislocation due to impalement of the femoral head on the ischial spine. He underwent urgent open reduction on presentation and subsequent internal fixation in a staged manner. He developed avascular necrosis at 18 months postoperatively. Conclusion: The nondisplaced ilioischial and iliopectineal acetabular radiographic lines were alerts that the dislocation was actually posterior. This led to further imaging before any closed reduction attempts because standard reduction maneuvers would have placed the patient at high risk for iatrogenic femoral head or neck fracture.

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“…The small osteocartilaginous fragments or radiolucent cartilaginous fragments are not visible in roentgenograms and can lead to nonconcentric reduction 51516. In nonconcentric reduction, the fragments inside the joint can abrade the articular surfaces and necessitating surgical removal 127.…”

Section: Discussionmentioning

confidence: 99%

Incongruent reduction following post-traumatic hip dislocations as an indicator of intra-articular loose bodies: A prospective study of 117 dislocations

Karuppaiah

Sundararajan

Dheenadhayalan

et al. 2011

IJOO

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Background:Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided.Materials and Methods:One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopic assessment of passive motion in the operating room as well as with good quality radiographs. Computerized tomography (CT) scan with 2-mm cuts was done for confirmation of reduction and to identify the anatomy of loose bodies. Patients with nonconcentric reduction underwent open exploration to identify the etiology of the dislocation and for removal of loose bodies. Thomson and Epstein clinical and radiological criteria were used to assess the outcome.Results:Twelve of the one hundred and seventeen (10%) dislocations had incongruent reduction, which was identified by the break in Shenton’s line and increase in medial joint space in seven patients, increase in the superior joint space in three patients, or increase in the joint space as a whole in two patients. CT scan identified the origin of the osteocartilaginous fragment as being from the acetabulum in six patients, the femoral head in four, and from both in one. One patient had an inverted posterior labrum. Following debridement, congruent reduction was achieved in all patients. At an average follow-up of 5 years (range: 2 years 5 months to 8 years), the outcome as evaluated by Thompson and Epstein clinical criteria was excellent in eleven cases and good in one case; the radiological outcome was excellent in eight cases and good in four cases.Conclusions:Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.

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Ipsilateral Anterior Then Irreducible Posterior Hip Dislocation Without Fracture: A Case Report

Cited by 6 publications

References 23 publications

Traumatic hip dislocations in an orthopedic center in Lagos

Traumatic hip dislocations in an orthopedic center in Lagos

Irreducible Traumatic Fracture-Dislocation of the Hip with Impalement onto the Ischial Spine

Incongruent reduction following post-traumatic hip dislocations as an indicator of intra-articular loose bodies: A prospective study of 117 dislocations

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