Recurrent traumatic dislocation of the hip in a child: Significance of early hip arthrography

Abstract

The authors describe a case of a recurrent posterior traumatic dislocation of the hip in a child in whom early arthrography demonstrated a large defect of the posterior capsule. The authors emphasize the necessity of prolonged immobilization and long-term follow-up. The operation of the patient was performed on the 7th day after the third recurrence of the dislocation. Revision and suture of the capsular defect from Gibson's approach were done.

A quantitative assessment of the insertional footprints of the hip joint capsular ligaments and their spanning fibers for reconstruction

“…The precise anatomy of the hip joint capsular ligaments and insertional footprints is becoming increasingly clinically significant. There have been many reports on procedures performed to stabilize the soft tissue structures of the hip (Liebenberg and Dommisse, 1969;Heinzelmann and Nelson, 1976;Slavik et al, 1986;Graham and Lapp, 1990;Lieberman et al, 1993;Bellabarba et al, 1998;Philippon, 2001;Matsuda, 2009;Blakey et al, 2010). This includes reconstruction of the hip joint capsular ligaments to restore stability to the hip during or following THA (Lavigne et al, 2001;McGann and Welch, 2001;Fujishiro et al, 2003;Cuellar et al, 2010;Van Warmerdam et al, 2011), these procedures target reinforcement of the ISFL posteriorly or ILFL anteriorly and have shown promising early results.…”

“…Similarly, if normal capsular healing fails to occur following traumatic hip dislocation resulting laxity may develop, thus predisposing the individual to hip instability (Graham and Lapp, 1990). Operative treatment of hip laxity and instability includes arthroscopic thermal capsulorrhaphy (Philippon, 2001), arthroscopic or open capsular plication (Liebenberg and Dommisse, 1969;Heinzelmann and Nelson, 1976;Slavik et al, 1986;Graham and Lapp, 1990;Lieberman et al, 1993;Bellabarba et al, 1998;Matsuda, 2009;Blakey et al, 2010) and proximal advancement of the posterior capsular origin (Bellabarba et al, 1998); all of which have been reported to successfully restore stability to the hip joint either alone (Liebenberg and Dommisse, 1969;Heinzelmann and Nelson, 1976;Graham and Lapp, 1990;Bellabarba et al, 1998;Philippon, 2001;Matsuda, 2009), or in conjunction with other soft tissue stabilization procedures (Slavik et al, 1986;Lieberman et al, 1993). One study even proposed that capsular repair alone is an effective treatment for recurrent dislocation of the hip joint (Heinzelmann and Nelson, 1976).…”

Hip Arthroscopy: Current Indications, Treatment Options, and Management Issues

“…58 The examination may also be affected by patient age; causes of hip pain should be separated into those relevant to the pediatric and adult populations. 92 Hip pain in the pediatric athlete includes skeletal causes such as hip dislocation, bony avulsion injuries, and fractures (stress and pathologic). Soft tissue origins of pain include myotendinous strains, apophyseal insertion site injuries, and contusions.…”

“…Non-traumatic causes include slipped capital femoral ephiphysis, Legg-Calvé-Perthes disease, developmental dysplasia of the hip, toxic synovitis, and septic arthritis. 80,92 In the adult, hip pain may originate from articular injuries including stress reaction or fracture; hip dislocation or subluxation; femur, pelvic or acetabular fractures; labral tears; avascular necrosis; and cartilage injury or degeneration. Soft tissue causes of pain include bursitis, snapping hip from the iliopsoas or iliotibial band, contusion, myotendinous strains, piriformis syndrome, myositis ossificans, inguinal or femoral hernia, neurologic irritation, and hamstring syndrome.…”

Hip

“…[188][189][190][191][192][193][194][195][196][197][198][199][200][201][202] Choyce described five cases of recurrent dislocation. 168 Mauck and Anderson reported a 6-year-old boy who had a subsequent dislocation 13 months after the initial injury.…”