Simultaneous asymmetrical bilateral hip dislocations – A report of three cases with different presentations and management

Abstract

Background: Simultaneous traumatic dislocation of both the hips in an individual is an uncommon injury. It accounts for only 1e2% of all traumatic hip dislocations. Simultaneous traumatic dislocation of both the hips in opposite directions i.e., anterior dislocation of one hip and posterior of the other is even rarer. These asymmetric dislocations need prompt identification for appropriate management. While their management should proceed in a manner commensurate with the accepted management of isolated dislocations to avoid complications, it is the timely identification which is essential. Study details: Retrospectively the details of three patients with asymmetric bilateral hip dislocations were collected. The article describes the clinical presentation of each patient and the management offered to them. The follow up duration ranged from 15 months to 24 months. Results: In the short term, the outcomes in terms of hip pain, movements at the hips and radiological parameters like absence of arthritic or avascular changes were found to be satisfactory in each patient. Conclusion: Early diagnosis and prompt reduction is the essential first step in the appropriate management of these patients to prevent the possible complications. The associated fractures must be managed as per the established principles of trauma care. Long term follow up is essential for identifying if complications like avascular necrosis and secondary osteoarthritis develop after this uncommon injury.

Luxação traumática bilateral assimétrica do quadril: Relato de caso

“…Conhecida também como “deformidade varrida pelo vento”, luxações assimétricas do quadril são raras em virtude das forças necessárias para gerar uma luxação anterior do quadril serem exatamente opostas àquelas necessárias para reproduzir uma luxação posterior. 2 6 O mecanismo do trauma em luxações posteriores resulta de uma força compressiva axial direcionada ao joelho, enquanto o quadril está em flexão e adução. De maneira oposta, em luxações anteriores do quadril, a força é aplicada com o membro em abdução e rotação externa.…”

“…No período entre 2015 e 2021, mais 17 casos foram identificados, ampliando para 121 casos na totalidade. 3 6…”

“…Also known as "wind-swept deformity", asymmetric hip dislocations are rare due to the forces required to generate an anterior hip dislocation being exactly opposite to those needed to reproduce a posterior dislocation. 2 6 The mechanism of trauma in posterior dislocations results from an axial compressive force directed at the knee while the hip is in flexion and adduction. Conversely, in anterior hip dislocations, the force is applied with the limb in abduction and external rotation.…”

“…In the period between 2015 and 2021, 17 more cases were identified, increasing to 121 cases in total. 3 6…”

Neglected simultaneous bilateral asymmetric traumatic hip dislocation in a young male managed by closed reduction manoeuvres in a resource-limited setting: A case report

“…Although early diagnosis and timely reduction are both essential in the appropriate management of patients with traumatic hip dislocations to prevent possible complications, closed reduction of chronic unreduced hip dislocations is associated with the development of avascular necrosis and arthritis [6] , [7] , [8] , [9] , [10] . Long term follow-up is therefore important for identifying these complications especially in the left hip of this unusual case of neglected bilateral asymmetric traumatic hip dislocations.…”