Total hip arthroplasty in neglected, obturator type, hip dislocation in a young adult – an unusual case and literature review

Patel, Sandeep; Thimmegowda, Ranganatha B.; John, Rakesh; Kumar, Tushar; Arjun, Rajalakshmi

doi:10.1016/j.jajs.2017.03.004

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Patel et al presented a case of 30 years old male who presented with pain having a history of trauma 15 years back. 9 Radiographs showed a neglected obturator dislocation of hip with a pseudo-acetabulum formation. Patient was managed by uncemented total hip arthroplasty and on 2 years followup patient was walking unaided without pain.…”

Section: Discussionmentioning

confidence: 99%

Restoring a near anatomical hip joint in an 18 year old neglected hip fracture dislocation – A rare case report

Mukherjee

Raja²

2022

IJOS

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Long standing neglected traumatic hip fracture dislocation is a rare clinical condition. Obliteration of the native acetabulum, soft tissue contractures, loss of femoral head congruity and associated hip fractures make this condition challenging to treat. We discuss a case of a middle-aged male presenting to us with pain, shortening and inability to bear weight on left lower limb for last 15 years. Clinical examination revealed an adduction deformity over the left hip, a globular swelling in the left gluteal region and a fixed equinus deformity over left ankle. Movements at the left hip hinted at restricted internal rotation and flexion. Pelvis radiographs revealed a neglected posterior hip dislocation with ipsilateral femur neck non union. Patient underwent initial upper tibial traction for 8 weeks followed by a hybrid Total Hip Arthroplasty. Postoperatively intensive physiotherapy was continued and with correction of the ankle equinus patient was able to ambulate. On five years follow-up, the patient was mobilizing independently, pain-free with a mild short limb gait and some residual foot drop.Treatment of neglected hip fracture dislocation can be challenging. Associated economic restraints may hinder clinicians from higher imaging and make the treatment even difficult. However, an anatomical reconstruction of hip by a total hip arthroplasty has yielded good functional outcomes in long standing neglected dislocations.’

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Section: Discussionmentioning

confidence: 99%

Restoring a near anatomical hip joint in an 18 year old neglected hip fracture dislocation – A rare case report

Mukherjee

Raja²

2022

IJOS

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“…Based on the characteristic of the patients included in the series, all three patients were female with adolescence group age. Although a standard definition of severe curve is missing in the literature, in some studies, a scoliotic curve is defined as large when the curve magnitude (measured with Cobb's method) is ≥ 61° and as rigid when curve Cobb angle reducibility is ≤ 30%, [8], [9] so the patients included in this study were considered to have either severe (patient 2), rigid (patient 3), or severe and rigid (patient 1). The two staged operation was considered in these patients because of the severity and rigidity of the curve and the Risser 2 skeletal maturity.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective review was undertaken of patients with severe and rigid scoliosis who had undergone two-staged operation in Orthopaedics and Traumatology Department of Prof Ngoerah General Hospital Bali during the period between January 2018 and February 2020. The criteria of severe scoliosis was one with curve magnitude (measured with Cobb's method) of ≥ 61°, whereas the criteria of "rigid" was one with curve Cobb angle reducibility of ≤ 30% [8], [9]. The Cobb angle reducibility of the spine was measured by using the following formula [5], [6], [10]: The data was obtained from the hospital's medical records and archives in our department.…”

Section: Methodsmentioning

confidence: 99%

Severe-Rigid Scoliosis Treated by Two-Staged Procedures: A Case Series

Wiguna

Ridia

Suyasa

et al. 2023

EJMED

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In developing countries, a large proportion of patients with scoliosis present late, especially the underprivilege, so the curves had become rigid and severe. There is still no consensus about the surgical management of the severe and rigid scoliosis and some literatures suggested that combined anterior and posterior or single-stage posterior-only instrumentation are generally required for the correction of these deformities. We presented three cases of severe rigid scoliosis treated surgically in our center with two staged operation (anterior surgery and posterior instrumentation). A retrospective review was undertaken of patients with severe scoliosis who had undergone two-staged operation in Orthopaedics and Traumatology Department of Prof Ngoerah General Hospital Bali during the period between January 2018 and February 2020. The data was obtained from the hospital’s medical records and archives in our department, included sex, age, the severity and reducibility of the Cobb angle, maturity rate, treatment, length of stay, complications found, and the Scoliosis Research Society: 30 Questionnaire (SRS-30) score before and three months after the surgery. During the period of between January 2018 and February 2020, there were three cases of severe rigid scoliosis who underwent two-staged operation. The two staged operation performed were anterior surgery (soft tissue release, corpectomy, and anterior fusion), and posterior instrumentation (facetetectomy, rotation, stabilization, and fusion). There were one case of intra-operative hypovolemic shock and anemia that could be corrected succesfully. All three patients showed no complaint and the clinical examination showed improvements of the deformity post operatively. There were also improvement of the total SRS-30 score of all three patients after the two staged procedures performed (mean = 4.4) compared to pre-operative score (mean = 3.4). The two-staged operation including anterior surgery and posterior instrumentation is still a safe and effective way in treatment of severe rigid scoliosis.

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“…Uncemented total hip arthroplasty was performed and after 2 years follow up, the patient was able to walk unaided without pain. 10 Ilyas et al, treated 15 patients with chronic unreduced hip fracture-dislocations result from motor vehicle injury at King Faisal Specialist Hospital & Research Center. All underwent 1-stage total hip arthroplasty with bone grafting and then monitored for 36-96 months range.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome after total hip replacement following 30 years neglected posterior hip dislocation: a rare case report

et al. 2020

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Neglected traumatic dislocations of the hip is one of disabling condition in lower extremity which are seldom found in adults. However, in developing countries, neglected-unreduced traumatic dislocations are not uncommon. Total hip replacement (THR) still remains a recommendation for the treatment of neglected hip dislocation which occurs more than 3 months. A 45- years-old female came to the outpatient clinic complaining pain on her right hip with history of trauma 30 years before, but instead of seeking medical treatment, she went to bonesetter instead. On physical examination, there is 5 cm leg length discrepancy, and the patient walked with limping gait. Conventional x-ray confirmed persistent dislocation of the right hip. A soft tissue release procedure and femoral neck osteotomy with skeletal traction was done before, followed by delayed THR two months after. The patient’s functional status was improved, and the HHS score increased from 48 to 87. The patient had no pain or significant complaints, except for a finding of mild residual Trendelenburg gait.

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Total hip arthroplasty in neglected, obturator type, hip dislocation in a young adult – an unusual case and literature review

Cited by 4 publications

References 12 publications

Restoring a near anatomical hip joint in an 18 year old neglected hip fracture dislocation – A rare case report

Restoring a near anatomical hip joint in an 18 year old neglected hip fracture dislocation – A rare case report

Severe-Rigid Scoliosis Treated by Two-Staged Procedures: A Case Series

Functional outcome after total hip replacement following 30 years neglected posterior hip dislocation: a rare case report

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