Traumatic Hip Dislocation in Children Younger Than 3 Years : A Series of 3 Cases

Abstract

ABSTRACT:The musculoskeletal anatomy of children is quite different from that of adults. The capsule, periosteum and other soft tissues surrounding the joints is very pliable and dislocations can occur even following trivial injuries. However dislocation occurring in a child population is a rare entity. There are a few case reports of hip dislocations in children < 3 years. We present here a series of 3 cases of paediatric hip dislocations which presented to us for management. The age of the children were between 24-27 months. Incidentally all 3 patients were boys and all 3 were right sided dislocations. None of them had any associated fractures. Two of them had a fall from height and one child fell off a slide. All 3 patients presented within 5 hours following injury. Closed reduction under anaesthesia was performed and post reduction the children were immobilized in a broom-stick plaster for 6 weeks. All children were followed up with serial x-rays and a MRI done immediately following reduction then at 6 and 18 months. There was no evidence of chondrolysis or avascular necrosis in any of the children at the last follow-up. They all had full range of movements with no limitation of function. We conclude that with early recognition and early reduction of the hip within the golden period (6 hours) the occurrence of complications can be prevented.

Posterior Dislocation Of The Hip Joint Due To Trauma In Children: A Three-Case Series

“…Posterior dislocation of the hip joint due to trauma in children is can cause many complications .the incidence of different complications is as follows: Nerve injuries in 5% 2,9 Avascular necrosis in 8% to 10%, Chondrolysis reported in 6% of the children. Follow up of all the three cases was uneventful and produced good long-term results when compared with adults 10 .…”

“…Dislocation of the hip joint in children who are younger than 16 years is extremely uncommon 2 , (0.8 cases per million/year) and around 80% of these present as posterior dislocations 2,9,10,11 . It is more common in boys (4:1) 8,9 .…”

“…Acetabulum is cartilaginous in young children therefore loose and flexible 2,3,4, thus permitting a trivial stress or trauma to cause dislocation 5,7,8,9,10 as the child grows there is calcification of cartilage resulting in a strong joint and ligament now a small trivial injury will not displace the hip joint 1,2,10 . U. Rashid, Z. U. Rehman, S. Khalil et al P J M H S Vol.…”

“…These techniques can establish the occurrence of small, fractured segments or intervening soft tissue 14 . If there is any incidence of any fragments or intervening tissue, reduction is tried again 3,4 , if this fails, then open reduction can be done via the posterior approach 3,4,10 .…”

Rupture of External Iliac Artery during Total Hip Arthroplasty after Rotational Acetabular Osteotomy: A Case Report

“…We further did a detailed search of the literature for traumatic pediatric hip dislocations in the Asian population, and we came across only two studies which had reported the entity ( Table 1 ) [ 5 , 6 ].…”