Traumatic Inferior-Anterior Hip Dislocation in a 15-Year-Old Without Fracture: A Five-Year Follow-Up and Review of...

Traumatic hip dislocations in the pediatric population are relatively rare but potentially devastating injuries, with anterior hip dislocations being even less common. These injuries typically result from high-energy trauma and direct impact mechanisms, most frequently due to motor vehicle accidents and, to a lesser extent, sports-related injuries. In adolescents, hip dislocations are often associated with fractures of the acetabulum or femoral head, necessitating urgent reduction under general anesthesia. Delays exceeding six hours significantly increase the risk of avascular necrosis (AVN) of the femoral head. The literature contains only a limited number of reported cases. We present a rare case of traumatic inferior-anterior hip dislocation without an associated fracture in a 15-year-old male with normal body habitus. The patient was brought to the emergency department after sustaining a direct impact to the left posterior hip following a collision with a moving vehicle. He presented with severe pain and tenderness in the left hip, a restricted range of motion, complete inability to move the left hip joint, and apparent limb shortening of approximately 5 cm. The patient underwent conservative management, with closed reduction performed under general anesthesia. He was followed for five years post-injury. To our knowledge, a five-year follow-up has not been reported in the English language literature. The patient subsequently underwent a structured rehabilitation protocol, including progressive weight-bearing and activity reintegration. A five-year follow-up evaluation ruled out avascular necrosis of the femoral head. Pure traumatic anterior hip dislocations are rare injuries, typically resulting from high-energy trauma. Prompt closed reduction under general anesthesia, often guided by fluoroscopy, is the preferred management approach. If closed reduction is unsuccessful, urgent open reduction should be performed. Long-term follow-up is crucial to monitor for complications such as avascular necrosis and joint dysfunction.