Traumatic Simultaneous Bilateral Hip Dislocation in the Elderly Patient: A Case Report

Traumatic simultaneous bilateral hip dislocation is reported rarely, but the most of them are limited in young patients. The authors managed the elderly patients whose both hip was dislocated traumatically, simultaneously and who didn't have any other underlying disease and other associated fracture - femur, hip joint and pelvis, with a review of the relevant literature.

Traumatic Simultaneous Bilateral Hip Dislocation in the Elderly Patient: A Case Report

Traumatic simultaneous bilateral hip dislocation is reported rarely, but the most of them are limited in young patients. The authors managed the elderly patients whose both hip was dislocated traumatically, simultaneously and who didn't have any other underlying disease and other associated fracture - femur, hip joint and pelvis, with a review of the relevant literature.

Neglected Traumatic Posterior Hip Dislocation in a Crutch-walking Patient: A Case Report

Traumatic posterior hip dislocation should be reduced emergently, but diagnosis could be delayed in a patient with head trauma or in developing countries. We have experienced neglected posterior hip dislocation for three months in a crutch-walking patient who had ipsilateral tibia fracture and alert mentality. Open reduction followed by six-weeks skeletal traction was performed. At one year follow-up, the reduced hip showed good range of motion with no evidence of avascular necrosis.

The treatment of posterior hip dislocation combined with femoral fractures / 中华创伤骨科杂志

Objective To discuss the treatment method and prognosis of posterior hip dislocation combined with femoral fractures. Methods Twenty nine patients who had been diagnosed as cases of posterior hip dislocation combined with femoral head fracture were reviewed, with their type of fracture, timing of treatment and method of treatment analyzed. Twenty seven (93.1%) of the 29 cases were followed up from 1987 to 2002 for an average period of seven years. Their prognosis was evaluated according to the x ray radiography and the function of hip joints. Results According to Pipkin IV classification, 13 cases were Pipkin Ⅰ(44.8%), 9 cases Pipkin Ⅱ(31%), 3 cases Pipkin Ⅲ(10%), and 4 cases Pipkin Ⅳ(14.2%). In type I, 9 cases were rated as excellent (33.3%), 2 good (7.4%), 1 fair (3.7%) and 0 poor (0%) by Harris hip score. In typeⅡ, 0 case was rated as excellent (0%), 2 cases good (7.4%), 4 fair (14.9%) and 2 poor (7.4%). In type Ⅲ, 1 case was rated as excellent, 0 good (0%), 1 fair (3.7%) and 1 poor (3.7%). In type Ⅳ, 0 case was rated as excellent (0%), 2 good (7.4%), 1 fair (3.7%) and 1 poor (3.7%). In all the 29 cases, those which needed total hip arthroplasty (THA) were four (13.7%). Conclusions The choice of treatment method should be determined by the mechanism of injury and the type of fracture. The factors ensuring a satisfactory prognosis are: (1) The age of the patients should be younger than 40 years. (2) Since a timely reduction can prevent the onset of avascular necrosis of femoral head, it should be finished within 12 hours after the injury, and the fixation should be done within 10 days. (3) In all types, early reduction of hip dislocation, early stabilization, anatomic reduction of the fracture should be achieved. (4) The prevention of possible complications should be taken into serious consideration.

Obturator Neuropathy after Traumatic Posterior Hip Dislocation: A case report

The obturator nerve is originated in lumbar 2, 3, 4 roots and inserted at the inner muscle of thigh, by way of sacral ala and obturator foramen. In the case of pelvic surgery or obstetric trauma, the obturator neuropathy is occasionally occurred. However, the obturator neuropathy is rarely seen in the orthopedic accident. In literature, one case of obturator neuropathy is reported after 2,012 cases of total hip replacement surgery. The useful diagnostic tools of obturator neuropathy are needle EMG on the obturater nerve innervated muscle, not conduction test on the nerve. We report of a case of obturator neuropathy after closed reduction of posterior hip dislocation complicated by traffic accident with a brief reviewed of literatures.

11 Cases Analysis of Traumatic Ireducible Posteior Hip Dislocation / 대한정형외과학회잡지

Simple posterior hip dislocations requiring open reduction is very few and reported approximately 3% of all posterior hip dislocations and we have little comments of the various causes preventing or blocking a concentric reduction following traumatic posterior hip dislocation. In a review of eleven cases of posterior dislocation requiring open reduction, we divided two groups, one is a failed closed reduction group, the other is a nonconcentric reduction group. A concentric reduction was prevented from an inverted limbus or an osteocartilagenous loose body from acetabulum or femoral head.

The Treatment of Femoral Head Fractures Associated with Posterior Hip Dislocations / 대한정형외과학회잡지

Femoral Head fracture associated with posterior dislocation of the hip was once considered a rare industrial injury. However, the advant of high-speed travel has contributed to its increased incidence. Ten cases of fractured femoral head with posterior dislocation of the hip were treated at the Busan Paik Hospital between June 1979 and June 1982. During the same period, a total of 38 posterior hip dislocations were treated. The patients were followed for the average of 19.3 months, the range being 6 months to 3 years. There were 9 men and 1 woman the age ranged from 25 to 56 years. The fractures were classified according to Pipkin and the results were evaluated by Epsteins criteria. 1. The incidence of femoral head fracture was 26.3%, 10 cases of 38 posterior hip dislocations. 2. The better result was noted in open method than in closed method. 3. The absolute surgical indications were considered as followings. a. inadequate closed reduction of head fragment especially the large one. b. the involvement of weight bearing portion of femoral head. c. the hip joint pain caused by impingement of small fragment between joint space. 4. Arthrogram was helpful to find the concealed small fragment when the hip joint pain persisted with negative findings in ordinary x-ray.