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Open posterior dislocation of hip in a 6-year-old boy: a rare case report
Pankaj Mahindra1, Ashwani Soni, Mohd Yamin
1aDepartment of Orthopaedics, Dayanand Medical College and Hospital, Ludhiana Departments of bOrthopaedics cPediatrics, GGS Medical College and Hospital, Faridkot, Punjab, India.
Insights
Open hip dislocation in children is rare and unstable. This case study details successful treatment using Kirschner-wires (K-wires) and a hip spica cast for a pediatric patient, establishing a potential protocol.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Open hip dislocation in pediatric patients is a rare and severe injury.
- Existing literature lacks established treatment protocols for this specific condition in children.
Observation:
- A 6-year-old boy presented with an open posterior hip dislocation, characterized by significant soft tissue damage leading to instability after reduction.
- The injury required immediate and comprehensive management to prevent infection and ensure joint stability.
Findings:
- Surgical intervention included thorough debridement and antibiotic administration to mitigate infection risk.
- Reduction was stabilized using nonthreaded Kirschner-wires (K-wires) under image intensification to minimize physeal plate damage.
- A hip spica cast was applied post-operatively to maintain K-wire integrity and prevent intra-articular breakage due to hip movement.
Implications:
- This case suggests a viable treatment approach for open posterior hip dislocations in pediatric patients.
- The described method, utilizing K-wire fixation and spica casting, may serve as a foundational protocol for managing this rare pediatric orthopedic emergency.
- Further research and case studies are warranted to validate and refine this treatment strategy.
Abstract:
Open hip dislocation in pediatric patients is a rare injury. Open posterior dislocation because of soft tissue damage is unstable after reduction. There is no treatment protocol in the literature for this injury in pediatric patients. We treated a 6-year-old boy presented with open posterior hip dislocation. Thorough debridement was performed and antibiotics were administered to prevent infection, and fixation of reduction with Kirschner-wires (K-wires) was performed. Nonthreaded K-wires were used under an image intensifier to minimize the risk of physeal injury. A hip spica cast was used to prevent the breakage of K-wires into the joint because of movements at the hip.
