What can be learned from 90 years of published literature on anterior-inferior hip dislocations in pediatrics?

This is a review of traumatic inferior hip dislocations in the pediatric population in light of a case in a 13-year-old pediatric patient with a focus on the management of a non successful closed reduction. The literature regarding inferior hip dislocation in the pediatric population was extensively searched to reveal joint conclusions regarding the presenting age, sex, mechanism of injury, associated injuries, time to reduction, type of reduction and managing surgical struggle and post-operative regimen. Cases retrieved from 1935 to 2025. Thirty-two eligible cases were included; 9 cases were females (28%). Seventeen cases were associated with concomitant dislocation and fracture (53%). Seven cases were open dislocations (21.8%). The average age was 10.4 years. The most common mechanism for injury was either motor vehicle accident (11) or fall (11). AVN was reported in 8 cases. Other complications were incarcerated labrum (2 cases), one infection without AVN, one case of overgrowth of the femur by 8 mm, one case of shortening and one case of coxa magna. Open reductions due to failed closed reduction were mentioned only in 2 cases. There was no consensus regarding follow-up management. Traumatic inferior dislocation in the pediatric population is a rare event but requires special attention. The risk for AVN is mainly associated with open dislocation or delayed treatment and therefore emphasize the importance of a reduction within 6 h of injury, if possible. For the follow-up management the conclusions recommend a short period of protected weight bearing 2-4 weeks, followed by gradual weight bearing as tolerated and follow up closely with an MRI. Level IV.