A Rare Paediatric Case Report of Neglected Traumatic Posterior Hip Dislocation

Abstract

Traumatic posterior hip dislocation in paediatric age group is a rare but potentially debilitating condition, particularly when neglected. The delay in seeking medical care frequently leads to missed diagnosis, which can lead to an array of future complications. Hence, timely intervention is crucial in treating neglected traumatic hip dislocations in children to prevent complications like avascular necrosis of femoral head, sciatic nerve injury and early degenerative arthritis. Various treatment options exist, ranging from closed reduction and hip spica application to surgical interventions like open reductions and osteotomies. The primary goal of any treatment modality in hip dislocation is to achieve concentric reduction and preventing the possible associated complications. Additionally, there is limited research evaluating the outcomes of closed reduction in neglected traumatic posterior hip dislocations specifically in children. The present case report aims to address this gap by presenting a case of a six-year-old female child with a neglected posterior hip dislocation following a fall from tree six weeks prior, which was managed with continuous traction followed by closed reduction and hip spica cast application. The serial follow-up of the child showed satisfactory clinical outcome as evidenced by improved hip range of motion and normal gait. The successful outcome supports the effectiveness of this approach in managing neglected traumatic hip dislocations in children. This case also emphasises that there should be attempts of closed reduction in all neglected paediatric hip dislocations, followed by hip spica application, before undertaking any surgical interventions, even if they present after six weeks.

Keywords

• avascular necrosis
• closed reduction
• hip spica