Traumatic hip dislocation in a 21-month-old child

Traumatic hip dislocation in the paediatric population is a relatively rare occurrence and constitutes an orthopaedic emergency. A trivial force is all that is required and non-accidental injury should not be necessarily suspected. A case report involving a hip dislocation in a 21-month-old child, the youngest in the recent English literature is detailed.     

儿童创伤性髋关节脱位的临床特点与治疗

目的 探讨儿童创伤性髋关节脱位的临床特点及治疗结果.方法 1990年1月至2006年12月收治的资料完整、随访超过2年的儿童创伤性髋关节脱位患者27例,男19例,女8例;年龄2.5～14.4岁,平均10.2岁.16例为高能量损伤,患者年龄(11.58±2.10)岁;11例为日常活动中受伤,患者年龄(8.30±2.93)岁.25例为后脱位,2例伤后自行复位者脱位方向不明.1例合并双侧股骨干骨折者初诊时漏诊.24例于伤后1～9h复位,其余3例复位时间超过24 h.21例闭合复位,6例切开复位.切开术中发现关节内骨软骨块3例,盂羼损伤嵌顿2例,关节囊嵌顿1例.复位后均采用单髋"人"字石膏制动4～6周.结果 27例中10岁以下者占48%.男女比例为2.4:1,左右侧别无差异.高能世损伤与低能量损伤患者年龄差异有统计学意义(t=3.392,P=0.002).全部病例随访2.4～8.3年,平均3.6年.按照Thompson和Epstein评价标准:优24例,良2例,可1例.末次随访时4例发生股骨头坏死,3例残留股骨头膨大和扁平髋.发生股骨头坏死者均为高能量损伤.延时≥24h复位组与<24h复位组股骨头坏死率的差异有统计学意义(X2=19.406,P=0.001).结论 儿童创伤性髋关节脱位所需创伤能量小,合并损伤少,10岁以前多为低能量损伤.闭合复位成功率高,并发症少.闭合复位不能达到中心复位者,可行切开复位及探查修复.24h内获得中心复位、无股骨头骺缺血坏死者疗效满意.     

双侧髋关节同时前后脱位1例

患者,男,55岁,敲击拆墙时被侧方倒落墙体压伤致双下肢活动不能及头皮出血2h入院。体检：右下肢内收、内旋、短缩畸形,左下肢外旋、外展屈曲畸形,双侧髋关节弹性固定,不能活动。双下肢感觉无殊,双足背伸跖屈肌力正常,头皮7cm裂伤伴活动性出血。     

Traumatic posterior hip dislocation in a 16-month-old child: a case report and review of literature

Traumatic posterior hip dislocation is an uncommon injury in children, constituting less than 5% of paediatric dislocations. In a younger child (<5 years), minor trauma such as a slip or fall from a low height may cause a hip dislocation, whereas in an adolescent a dislocation is usually caused by a major trauma such as motor vehicle accident. In this case report we present a rare case of traumatic hip dislocation in a 16-month-old girl. Early detection and closed reduction ensured good outcome in our case. A high index of suspicion is necessary to achieve satisfactory reduction within six hours of dislocation because reduction after this period will greatly increase the risk of complications.     

髋关节前脱位伴同侧股骨粗隆下骨折救治1例

患者,男,22岁,因重物砸伤致右髋、右大腿肿胀、腹股沟区疼痛1.5 h,于2009年5月17日收住入院.患者为建筑工,在搬运重物时,重物倒塌,砸伤右髋、右大腿,当即致右髋和右大腿肿胀、疼痛、活动障碍,当时患者无昏迷、胸闷气促、恶心、呕吐、腹痛、腹胀等不适.     

Open anterior dislocation of the hip in child of 7-years-old: A case report and literature review

Traumatic hip dislocation is a rare injury in children, and an open dislocation is exceptional. We report the case of a 7 year old patient who presented an open anterior dislocation of the left hip following trauma by accident of the public highway. The patient received treatment under general anesthesia: articular toilet, debridement and reduction. Then, He was put under traction for 6 weeks and antibiotic. The short term evolution is marked by the occurrence of post-traumatic septic arthritis and osteonecrosis of the femoral head after two months.     

人工全髋关节术后脱位的预防及治疗

术后髋关节脱位是人工全髋置换术(THR)后严重的并发症,如处理不善,常会引起严重的下肢功能障碍,导致关节手术失败.1994-2001年,我院共行THR手术436例,其中术后发生脱位有11例,加上外院转入5例,共16例,现报告如下.……     

Traumatic bilateral posterior hip dislocation in 10 year old male child

Traumatic bilateral posterior hip dislocation in skeletally immature patient is reported very less in literature. We report a 10 yr old boy presented to us following farmyard injury with bilateral posterior hip dislocation, which was reduced manually under sedation with uneventful follow-up and complete hip range of motion at 2 year.     

Congenital dislocation of the hip

Summary The results of early diagnosis and treatment of congenital dislocation of the hip (CDH) in Malmö were investigated. In 60,000 live births, 4 cases were missed in the newborn. Clinical and radiological re-examination including anthropometrical measurements at the average age of 10.3 proved that all treated hips were normal.

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Résumé Etude des résultats obtenus à Malmö grâce au diagnostic et au traitement précoce de la luxation congénitale de la hanche (CDH).Sur 60.000 nouveaux-nés vivants, seuls 4 cas de luxation ont échappé à l'examen post-natal.Le bilan clinique et radiologique, comportant des mensurations anthropométriques, pratiqué à l'âge moyen de 10 ans 4 mois, prouve que toutes les hanches traitées sont normales.

     

Habitual dislocation of the hip

Summary We report the case of a girl, aged 2 years, who was able to dislocate her right hip voluntarily and in whom there was no other abnormality. She was given psychological treatment and the condition resolved after 2 years. Eight similar cases of habitual dislocation of the hip are reported in the world literature.

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Résumé Les auteurs rapportent l'observation clinique d'une luxation volontaire de la hanche chez une petite fille de deux ans qui ne présentait pas d'autres anomalies. Cette malformation ne fut traitée que par des moyens psychologiques et disparut complètement en l'espace de deux ans. 8 cas seulement, en plus de celui-ci, ont été retrouvés dans la litérature mondiale. En revoyant celle-ci, on constate que les résultats obtenus par les auteurs sont identiques à ceux qui ont été publiés auparavant.

     

Traumatic anterior dislocation of the hip

Summary An unusual traumatic anterior dislocation of the hip in a 47-year-old woman is reported. The mechanism of trauma behind anterior hip dislocations and their diagnosis are described and the prognosis of hip dislocations in general is mentioned.     

Traumatic anterior dislocation of the hip

Summary A discussion is presented of traumatic anterior dislocation of the hip joint on the basis of three representative case reports. One patient had an iliac or pubic dislocation, the other two were obturator dislocations, including one with an associated femoral head fracture. All three patients were treated without surgery. After an average follow-up time of twenty-seven months, the results were excellent. Therepeutic guide-lines and recommendations are given for this infrequent type of injury.     

Traumatic anterior dislocation of the hip

A case of traumatic anterior dislocation of the hip is presented. Reduction was easily achieved but was unstable because of disruption of the iliofemoral ligament by detachment of the anterior inferior iliac spine. A stable reduction was achieved by operative reattachment of the anterior inferior iliac spine.     

Traumatic anterior dislocation of the shoulder in a child

Summary Dislocation of the shoulder joint is a rare occurrence in children. This paper reports on traumatic anterior dislocation of the shoulder in a 3-year-old boy and a 9-year-old boy, together with a discussion of the relevant literature.     

Ipsilateral open anterior hip dislocation and open pos- terior elbow dislocation in an adult

Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been de- scribed in English language-based medical literature. Pri- mary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted ingood clinical outcome in our patient. At 18 months follow- up, no signs of avascular necrosis of the femoral head or infection were observed.     

Traumatic anterior dislocation of the hip in childhood

One hundred and eleven traumatic anterior dislocations of the hip in children were collected from the literature and statistically evaluated together with 4 cases treated at our institute. The incidence of open dislocations, associated lesions (avulsion of the greater trochanter, damage to the femoral vessels, and fracture of the shaft of the ipsilateral femur), and irreducible recent dislocations was noteworthy, demanding special methods of primary management. In 41 patients, with follow-up averaging 5 years, the incidence of complications, especially avascular necrosis, was also high. Anterior dislocation of the hip in this age group is to be considered a serious injury. Concerning the final state of the hip-joint, factors giving a poor prognosis appear to be severe injury, open dislocation, associated fractures near the joint, delayed reduction, and, possibly, open procedures.