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Traumatic dislocation of the hip in children
Insights
Traumatic hip dislocation in children often involves soft-tissue interposition requiring surgery. While most hips appear normal clinically after treatment, radiographic changes like coxa magna are common.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Hip Biomechanics
Background:
- Traumatic hip dislocation is a significant orthopedic injury in children.
- Understanding the long-term outcomes and complications is crucial for effective management.
- Previous studies have varied in their findings regarding sequelae.
Purpose of the Study:
- To review the outcomes of traumatic hip dislocations in children treated over a 17-year period.
- To identify common complications and their management.
- To assess the long-term radiographic changes and their correlation with clinical results.
Main Methods:
- Retrospective review of 33 children with traumatic hip dislocation treated between 1960 and 1977.
- Analysis of trauma mechanisms, complications, surgical interventions, and follow-up data.
- Clinical examination and radiographic assessment (including measurements for coxa magna) at an average of 10-year follow-up.
Main Results:
- Younger children experienced dislocations with less severe trauma compared to older children.
- Soft-tissue interposition was the most frequent complication, often necessitating posterior arthrotomy.
- Radiographic analysis revealed coxa magna (≥2 mm) in 47% of hips, unrelated to clinical outcomes.
Conclusions:
- Traumatic hip dislocation in children can lead to significant soft-tissue complications requiring surgical intervention.
- Despite good clinical results in most cases, long-term radiographic changes such as coxa magna are prevalent.
- The development of coxa magna does not appear to negatively impact the overall clinical outcome of the hip.
Abstract:
Thirty-three children with traumatic dislocation of the hip who had been treated at the Hospital for Sick Children between 1960 and 1977 were reviewed. The amount of trauma causing dislocation of the hip in younger children was less than that for older children. The most frequent complication was soft-tissue interposition which usually required a posterior arthrotomy to clear the interposed tissue. Less frequent complications included avascular necrosis, redislocation of the hip and an irreducible hip. Nineteen children were reviewed with an average follow-up time of 10 years. Clinical examination indicated that 84 per cent of these hips were normal but the radiographs showed that 47 per cent of the dislocated hips had a coxa magna of two millimetres or more. There was no correlation between the development of coxa magna and the clinical result.