Surgical treatment of a traumatic open anterior hip dislocation in a child: A case report and review of 13 cases in the literature

Abstract

Due to the high probability of infection and avascular necrosis, traumatic open anterior hip dislocation poses a serious orthopedic emergency. Despite the emergency of the issue, it appears to be an under-researched topic in the literature. In this study, we present open anterior hip dislocation with both trochanteric fractures in a child and review other pediatric cases from the literature. Because of rareness, there is no standard surgical and postoperative treatment algorithm. We discussed the mechanism of injury, wound size, time of the reduction, associated injury, type of treatment, type of immobilization, clinical and functional results to present a collective perspective on the literature. Once we have compared all of these situations, dealing with infection is key to satisfactory clinical and functional outcomes. The early reduction was the most important point in both coping with infection and preserving avascular necrosis of the femoral head.

Keywords: Anterior; Open; Pediatric; Traumatic hip dislocation.

Fig. 1

a) First admission to the hospital and protrusion of the left femoral head with a 15-cm-long inguinal wound b) Lower extremity in flexion, abduction and external rotation prior to surgery c) Pelvis AP radiograph d) After debridement and irrigation e) After reduction and fixation intraoperative fluoroscopy (AP) f) Intraoperative fluoroscopy (Lateral).

Fig. 2

a) Subluxation in the left femoral head five weeks later b) Free, infected, and chondrolyzed femoral head c) Fixation of femoral neck and acetabulum d) Final follow-up pelvis AP radiograph e) Final follow-up lower limb length radyograph.