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Neglected traumatic hip dislocation in children.

Sudhir Kumar1, Anil K Jain

  • 1University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi 110 095, India. sudhirkumar@hotmail.com

Clinical Orthopaedics and Related Research
|February 3, 2005
PubMed
Summary

Open reduction is a successful treatment for neglected pediatric hip dislocation, even with avascular necrosis. This procedure restores hip function and prevents long-term limb deformities in children.

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Area of Science:

  • Pediatric Orthopedics
  • Traumatology
  • Pediatric Surgery

Background:

  • Traumatic hip dislocation in children is infrequent.
  • Delayed diagnosis often leads to neglected dislocations, complicating treatment.
  • Neglected dislocations can cause persistent pain, deformity, and gait abnormalities.

Purpose of the Study:

  • To evaluate the outcomes of open reduction for neglected traumatic posterior hip dislocations in pediatric patients.
  • To determine the efficacy of open reduction in improving function and preventing deformity.
  • To assess the impact of avascular necrosis on treatment outcomes.

Main Methods:

  • Retrospective review of 18 children with neglected traumatic posterior hip dislocations.
  • All patients underwent open reduction due to failed closed reduction attempts.

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  • Radiographic assessment included evaluation for avascular necrosis (osteonecrosis) and joint space preservation.

    • Main Results:

    • Seventeen out of 18 children achieved excellent functional outcomes at short-term follow-up.
    • All hips presented with some degree of avascular necrosis but preserved joint space.
    • Open reduction was necessary as skeletal traction was ineffective.

    Conclusions:

    • Open reduction is a satisfactory treatment for neglected pediatric hip dislocations.
    • Anatomical reduction promotes proper femoral head growth stimulus, preventing deformity.
    • This surgical approach effectively maintains limb length and improves function.