Anterior Inferior Hip Dislocation: Report of Three Cases and Review of Literature

Abstract

Introduction: Inferior dislocation of the hip, also called luxatio erecta femoris, is the rarest type of hip dislocation with a poorly understood mechanism of injury. We came across three such cases resulting from high-energy trauma with various other associated injuries. Case Report: The first patient, a 25-year-old man, presented with the right hip pain, hip and knee joint in flexion without rotational component, after motor vehicle collision. The second patient, a 42-year-old man, presented with the left hip pain, hip and knee joint in flexion with rotational component, following fall from 20 ft height. The third patient, a 29-year-old lady, presented with the left hip pain, hip and knee joint in flexion with rotational component, after motor vehicle collision. All three patients were diagnosed by radiograph and were managed by closed reduction under short general anesthesia, within 3 h, 9 h, and 6 h, respectively. Thomas splint was used to immobilize the limb in all for 1 month and weight-bearing was started after 2 months from injury. Two of them were followed up to 6 months and one was lost to follow up. No evidence of avascular necrosis of femoral head or other complication related to hip dislocation was noted. Conclusion: Luxatio erecta femoris is a rare type of hip dislocation and with limited publication. The position of limb on presentation should raise the suspicion of same and diagnosis confirmed through radiological investigations. Usually, this type of dislocation can be managed with closed reduction. If closed reduction is unsuccessful, then a fracture femur or bone chip in the joint could be the cause of the difficulty. Keywords: Hip, dislocation, inferior, luxatio erecta femoris.

Isolated Luxatio Erecta Femoris – Case Series and Review of Literature

“…MEDLINE, PubMed, and Google Scholar were searched using the key words: “‘Hip”’ and “‘inferior dislocation”’ or “‘luxatio erecta femoris”’ or “‘infracotyloid dislocation’.” A total of 21 articles reporting on 24 men and 6 women aged 5– to 56 (mean, 25) years with 28 unilateral and one bilateral inferior dislocation of the hip were reviewed ( Table 1 ) [ 2 , 3 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Two patients had a concurrent displaced fracture of the ipsilateral proximal femur.…”

“…Four patients were lost to follow- up. [ 13 , 14 , 16 , 27 , 28 ]. A limitation of this study was that meta-analysis was not performed and that only case reports and case series were reviewed.…”