Neglected hip dislocation: an unusual presentation, its management and review of the literature

Abstract

Neglected traumatic posterior hip dislocation is not an uncommon condition seen in developing countries. Its treatment is fraught with great difficulties and controversies. Here we present a 31-year-old female patient presented to our hospital 2 years after sustaining an accident. She had gone through multiple treatments for her dislocated hip without any success. After arrival to our hospital, patient managed by constrained total hip replacement (THR). Her Harris hip score improved from 48 (preoperative) to 81 (postoperative). On follow-up she had a good range of movement of the hip with no pain, deformity and limb length discrepancy. Constrained THR provides promising results in neglected hip dislocation.

Primary Complex Total Hip Arthroplasty in Neglected Anterior Hip Dislocation With Comminuted Pertrochanteric Femur Fracture

“…The patient had a relatively stable hip with a satisfactory range of motion. Furthermore, Kumar et al [1] successfully treated 2-year-old hip dislocation by THA with subtrochanteric osteotomy.…”

“…However, a delay of more than 3 months leaves the surgeon with minimal choices. Although THA is a good option in such cases, some authors report the use of subtrochanteric osteotomy, the Girdlestone procedure, hip arthrodesis, or hemiarthroplasty [ 1 ]. The optimal treatment for such neglected cases of hip dislocations is still controversial.…”

“…Unreduced traumatic hip dislocations are common in developing countries and are often due to road traffic accidents [ 1 ]. In such situations, reduction techniques should be applied within 6 hours of injury [ 2 ].…”

“…Neglecting such injuries leads to difficulty in reduction and increases the risk of avascular necrosis. Furthermore, as time progresses, reduction by closed means becomes impossible, and if the delay is greater than 3 months, open reduction also ceases to be viable [ 1 , 3 ]. The potential options for these types of cases are total hip arthroplasty (THA) or osteosynthesis [ 3 , 4 ].…”

Luxación traumática recurrente de cadera asociada a fractura de cabeza femoral reconstruida con autoinjerto de cresta ilíaca

“…Recurrence of hip dislocation is extremely uncommon, even if there is no acetabular fracture. In delayed-diagnosed dislocation, it has employed total hip arthroplasty (THA), with constrained implants (Kumar, et al, 2017) to prevent hip instability. Reconstruction with iliac crest graft for treating acetabular injuries is not a novel concept.…”