Management of Posttraumatic Neglected Hip Dislocation in Adults: A Case Series

Neglected hip dislocation in adult is relatively a rare entity but not so uncommon in the developing world due to many factors including lack of awareness, poor socioeconomic status, illiteracy, poor transportation, distant location from towns, lack of well-equipped hospitals, and skilled medical personnel. Its management becomes challenging as close reduction becomes almost impossible and there are increased chances of avascular necrosis (AVN) of the femoral head and so arthritis of hip joints later on. There is no clear-cut management protocol available in the literature regarding it. Some orthopedician prefer open reduction of hip joint and some prefer total hip arthroplasty (THA).

In our series of 3 cases, One patient who had neglected hip dislocation of 2 months duration without AVN changes in magnetic resonance imaging (MRI) underwent open reduction, whereas another two cases with neglected hip dislocation of more than 3 months durations (12 months and 6 months) undergone primary THA.

Primary THA should be done in neglected hip dislocation of duration more than 3 months but the open reduction of the hip joint can be tried if the duration of dislocation is <3 months without AVN changes of the femoral head in MRI.