Update review and clinical presentation in adult inferior dislocation of hip

Abstract

Inferior dislocation of the hip is a rare clinical entity, wherein closed reduction maneuver could be challenging, especially if the attending surgeon is not familiar with the specific anatomy associated with this injury. Due to the rarity of this type of injury, large case series are lacking in the literature; hence, case reports form the major source of our knowledge regarding the clinical presentation and management. An extensive literature search revealed a change in age group presenting with this specific injury, with a male predilection. They were frequently cited in the pediatric age group of less than 16 years in the last century. Recently, the cases have been documented in adults. An up-to-date review of the current literature on the mechanism of injury, clinical presentation, management, outcomes and complications of inferior dislocation of hip has been highlighted in this article. In addition, we share our experience with three such dislocations presenting in adult males with an age range of 38-62 years.

Old unreduced obturator dislocation of the hip: A case report

“…There is no consensus on the management of hip dislocation after either open or closed reduction. Post-reduction immobilization using traction or cast and non-weight-bearing were recommended for the prevention of femoral head necrosis[ 5 , 26 ]. For old unreduced dislocation, traction is not only to reduce the risk of avascular necrosis, but also to ameliorate soft tissue contracture around the hip joint.…”

“…For old unreduced dislocation, traction is not only to reduce the risk of avascular necrosis, but also to ameliorate soft tissue contracture around the hip joint. The time of traction and non-weight-bearing following hip reduction is highly variable, ranging from 1 wk to 6 wk in traction and 2 wk to 12 wk in non-weight-bearing [ 4 , 5 , 7 , 8 , 11 , 14 , 18 , 20 , 22 , 26 ]. Although a few studies in recent years have shown that traction did not change the risk of avascular necrosis and prognosis[ 5 ], 6-wk skin traction and totally 8-wk non-weight-bearing were applied for our patient.…”

“…Only 5%-13% of all hip dislocations are traumatic anterior dislocations, which occur less frequently than posterior hip dislocations[ 1 - 5 ]. According to Epstein’s classification, anterior dislocation is divided into pubic and obturator dislocation based on whether the femoral head is displaced superiorly or inferiorly[ 6 ].…”