Traumatic Posterior Hip Dislocation in a 5-Year-Old: A Case Report and Review of the Literature

Case Report

Austin J Orthopade & Rheumatol. 2015;2(1): 1013.

Traumatic Posterior Hip Dislocation in a 5-Year-Old: A Case Report and Review of the Literature

Adam D. Bitterman¹*, Brett Auerbach¹, Shalin Shah³ and Francisco Javier Laplaza²

Department of Orthopedic Surgery, Plainview Hospital,USA

New York Institute of Technology College of Osteopathic Medicine, USA

Department of Pediatric Orthopaedic Surgery, Cohen Children’s Medical Center, USA

*Corresponding author: Adam D. Bitterman,Department of Orthopaedic Surgery, Department of Medical Education, NS/LIJ Plainview Hospital, 888 Old Country Road, 25 Building, Plainview, NY 11803, USA, Tel: (516) 719-2546; Fax: (516) 719-2766; Email: Adam.Bitterman@gmail.com

Received: November 20, 2014; Accepted: March 19, 2015; Published: March 26, 2015

Abstract

Traumatic hip dislocations in children are uncommon, yet constitute an orthopaedic emergency. Furthermore, the insignificant mechanism of injury oftentimes leads to a potential miss or delay in diagnosis. The nature of the injury may seem minor so as to not pursue further workup. For this reason it is imperative to have a high index of suspicion, as clinical assessment and judicious imaging are key to obtaining the patient’s correct diagnosis. Although there are various complications that may result from such an injury, the most commonly encountered and most catastrophic is Avascular Necrosis (AVN), of the femoral head; early concentric reduction is crucial in minimizing this risk and optimizing patient outcomes.

Case Report

This is a case of a 5-year-old, Caucasian male with no significant medical history, who presented with severe left hip pain as well as a deformed left lower extremity. His parents reported that he was playing with his cousin when he suddenly fell and was no longer to able to bear weight on his left leg. The injury occurred roughly thirtyfive minutes prior to arrival at the emergency department.

Upon physical examination his left lower extremity was flexed at the hip, internally rotated and slightly adducted. He had no sensory or motor deficits and his pulses were palpable at the dorsalis pedis and posterior tibial arteries. His foot was warm and well-perfused. Radiographic evaluation of the pelvis and hip demonstrated a posterior native hip dislocation without any obvious fractures (Figure 1,2).