Cases reported "Hip Dislocation"

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1/14. Traumatic posterior dislocation of hip in children.

    Traumatic posterior dislocation of the hip joint in children is an uncommon injury. It constitutes a true orthopedic emergency. It makes up over 80% of pediatric hip dislocations. In children, it can occur as a result of minimal trauma, which is attributed to a soft pliable acetabulum and ligamentous laxity. In skeletally mature adolescents, a greater force is required to dislocate the hip joint. Delay in reduction is associated with long-term complications such as avascular necrosis and degenerative arthritis. Avascular necrosis is related to the duration of dislocation. A poorer prognosis is associated with delay in reduction beyond 6 hours, advanced skeletal maturity, or multiple traumas. Prompt reduction minimizes complications. We report two cases of traumatic posterior dislocation of hip in children aged 3 and 14 years. Both were reduced within 6 hours of dislocation, and review at 6 months revealed normal examination and no evidence of any post-traumatic changes. Post-reduction treatment remains without a consensus. This review highlights the clinical presentation, management, and time-sensitive complications of the injury.
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2/14. Successful open reduction of a 5-month-old hip dislocation associated with a femoral head fracture.

    The long-term prognosis after open reduction of neglected posterior hip dislocations is poor; as such, primary arthroplasty is recommended by a number of authors. We present a patient with a 5-month-old posterior hip dislocation with concomitant paralysis of the sciatic nerve who had an open reduction. At a follow-up of 3.5 years, the patient has normal function with no signs of arthrosis. magnetic resonance imaging scans, however, revealed partial avascular necrosis of the femoral head. A discussion based on the literature shows the uniqueness of this case.
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3/14. Late open reduction of traumatic dislocation of the hip. Report of three cases.

    Three patients were reviewed seven, eight and fourteen years after delayed open reduction of traumatic posterior dislocation of the hip. The delay between injury and operation varied from twenty-eight to ninety-three days. At the time of review symptoms were minimal or absent, and in all cases the injured hip was clinically normal. Radiological examination showed loss of articular cartilage in one hip and trabecular changes in the bone of all three. On the basis of these three results the traditional pessimism about prognosis in such cases may not be justified.
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4/14. Hip fracture-dislocation with transepiphyseal separation. Case report and literature review.

    Fracture-dislocation of the hip is an infrequent injury in adolescence. In combination with transepiphyseal separation of the capital femoral epiphysis, the injury is rare and catastrophic. A review of orthopaedic literature shows varied recommendations as to treatment approaches. The most recent articles have suggested that open reduction through a posterior approach and internal fixation is the best way to treat this problem initially. Later reconstructive measures are usually required because this injury often leads to avascular necrosis of the femoral head. The patient and family should be advised that the prognosis after such a fracture-dislocation is not good. Potential reconstructive measures after collapse of the femoral head include total hip arthroplasty and hip arthrodesis. Total hip arthroplasty is not a reliable means of providing a long-term painless joint in an active adolescent with one-joint disease. Hip arthrodesis has been shown to be a good alternative treatment for patients who develop avascular necrosis after this severe injury.
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5/14. Long-term progression of a case of trans-epiphyseal fracture-dislocation of the proximal epiphysis of the femur.

    Epiphyseal detachment-dislocation of the proximal femur constitutes a traumatic lesion, the immediate resolution of which always requires surgical treatment. How early treatment is carried out is important in improving the prognosis of the lesions which, however, in most cases is poor. In our case, clinical examination made 6 years post-surgery shows satisfactory preservation of range of movement with no important subjective disorders and with a minimal amount of hypometria (1 cm) even if structural epiphyseal changes visualized on radiographic examination and CT scan predict progression towards early arthritic degeneration.
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6/14. Traumatic anterior dislocation of the hip. Case report.

    An unusual traumatic anterior dislocation of the hip in a 47-year-old woman is reported. The mechanism of trauma behind anterior hip dislocations and their diagnosis are described and the prognosis of hip dislocations in general is mentioned.
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7/14. Subluxation of the hip joint during femoral lengthening.

    Three cases of subluxation of the hip joint occurred during femoral lengthening using the Wagner technique. This infrequent complication, which may result from a conflict of force vectors at the hip joint during lengthening, can, when left untreated, nullify the benefits of such a procedure. We suggest that increased awareness and closer monitoring can improve the prognosis for patients undergoing this course of therapy, especially where a previous hip operation has been performed.
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8/14. Traumatic hip dislocation with ipsilateral femoral shaft fractures.

    A traumatic dislocation of the hip joint associated with an ipsilateral femoral shaft fracture is a rare injury resulting from severe trauma. Initially the dislocated hip joint is often unrecognized and consequently reduction is delayed. early diagnosis and reduction of the hip joint improves the functional prognosis. The maximum functional recovery is possible only with greater awareness of this combined injury. Examination of the hip joints by clinical roentgenography in the critically injured patient, especially those with head injuries, or physical signs masked by extremity swelling, should be a routine procedure.
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9/14. Traumatic dislocation of the hip in adolescence with separation of the capital epiphysis. Two case reports.

    Fracture separation of the capital femoral epiphysis occurring during attempted closed reduction of a traumatic dislocation of the hip is described in two adolescents. Although this complication is extremely rare, the prognosis of fracture separation with dislocation of the epiphysis is known to be poor. Avascular necrosis subsequently developed in both cases. The importance of gentle manipulative reduction under general anaesthesia with complete muscle relaxation is emphasised.
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10/14. Computerized tomography for ascertaining osteocartilagenous intraarticular (slice) fractures of the femoral head.

    Posterior dislocation of the hip joint is the result of severe trauma and leaves those affected with a significant degree of morbidity. Avascular necrosis of the femoral head is its most feared, and yet difficult to diagnose, complication, mainly in the immediate postinjury period. Intraarticular (slice) fractures of the posteroinferior and inferomedial aspects of the femoral head associated with such dislocations may cause the same clinical symptomatology as the sequelae of avascular necrosis, yet need a different approach and have a different prognosis. Since these slice fractures occur in a blind spot area for routine radiographic examinations of the hip, they are often missed and consequently underdiagnosed. Computerized tomography of the hip following posterior dislocation has become a most useful tool in ascertaining the diagnosis in these patients because it very clearly delineates such "slice" fractures, thus enhancing the correct assessment of this severe and often crippling injury.
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