Simultaneous anterior and posterior traumatic dislocation of the hip

Abstract

The presence of anterior dislocation of the hip along with contralateral posterior dislocation of the hip in the absence of other major trauma is a distinctly rare injury pattern. We report such a case resulting from a motor vehicle striking a pedestrian, along with a review of previous cases. The patient was managed nonoperatively within 6 hours of trauma with an excellent final outcome and no posttraumatic complications over a 3-year follow-up. The possible mechanism of this injury is discussed.

Bilateral Asymmetric Dislocations of Hip Joints: An Unusual Mechanism of Injury

“…Agarwal et al reported it to be 1.25% of the total reported hip dislocations [1]. Bilateral asymmetric dislocations of hip are even rarer, and only limited number of cases have been reported.…”

“…Examining the various modes of injury described in published studies for bilateral asymmetric dislocations of the hip joints, they ranged from pedestrian being hit by a car to head on collision of vehicles and motorcycle crash [1, 2, 8]. The single common mechanism involved in most of these cases was a sudden deceleration injury.…”

“…Most researchers are of the view that incidence of avascular necrosis (AVN) of the femoral head is often determined by the delay in reduction of the dislocated hip [1–3, 5]. The risk of AVN may range from 8% to 15% in closed reduction cases and may go up to as high as 40% in cases requiring operative reduction [2].…”

“…The risk of AVN may range from 8% to 15% in closed reduction cases and may go up to as high as 40% in cases requiring operative reduction [2]. Agarwal et al have recommended a routine magnetic resonance imaging (MRI) scan at around three months following injury for early detection of AVN [1]. Incidence of posttraumatic arthritis has been stated to be approximately 24% in patients of hip dislocations [3–5].…”

“…But simultaneous bilateral hip dislocations only constitute 1.25% of all hip dislocations [1]. Simultaneous one-side anterior and one-side posterior hip dislocations (asymmetric dislocation) are even less common [1]. Hip joint being an inherently stable joint requires a significant amount of force to dislocate [2, 3].…”