International Journal of Advances In Case Reports

TRAUMATIC HIP DISLOCATIONS IN CHILDREN - SERIES OF TWELVE CASES

Humayun Ahad1*, Hayat Ahmad Khan2, Nazia Hassan3, Arshad Bashir4, Ishtiyaq Abdullah5, BG Nair6

humayunahad@yahoo.com

Traumatic Dislocation, Hip, children.

Traumatic dislocations of hip in children are of rare occurrence and are often missed in the busy orthopaedic hospitals. Usually they present late with complaints of persisting pain, deformity and limp. Early diagnosis is of utmost importance to prevent the hazardous complications. This is the first study reported from India where traumatic hip dislocations were diagnosed early and managed without any complications. Twelve children with traumatic hip dislocations were treated during a period of six years at two orthopaedic centres. Closed reduction followed by immobilisation was done for four weeks. Patients were followed up for minimum of one year and any complication noted. Among the cohort of 12 patients, we had eight male and four female patients. The age group varied from Two years to thirteen years with the mean age of seven years (Range =2 to 13 years, mean=7.2 years). All the hips were dislocated posteriorly. Eight hips were reduced during 24 hours and four hips after 24 hours. All the hips were reduced by closed methods. Hips were then supported by either hip Spica or Skin traction for four to six weeks. No complication with respect to avascular necrosis of head of femur (Ficat staging), nerve injury, limp, pain on weight bearing, recurrent dislocation or loss of reduction was seen on final follow up. No difference was also noted in the Spica group or skin traction group. Traumatic dislocation of hip in children is not uncommon. Regarding the low energy trauma required in this kind of dislocation and long-term and hazardous complications due to the delayed diagnosis, it is important to consider the probability of hip dislocation in traumatic child. An early reduction is an absolute priority to decreases the risk of Avascular necrosis.