Mishra Dipun, Jain Mantu, Tripathy Sujit Kumar, Singh Amit Kumar, Singh Avnish Kumar
Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Orthop Case Rep. 2024 Aug;14(8):141-147. doi: 10.13107/jocr.2024.v14.i08.4678.
Traumatic hip dislocations frequently result from road traffic accidents and are prevalent in developing nations. Untreated dislocations either due to ignorance or lack of proper treatment become more challenging to manage and have an increased likelihood of developing avascular necrosis (AVN). Over time, closed methods of reduction become impractical, and if the waiting period surpasses 3 months, open reduction likewise becomes unworkable. Anterior dislocations are less common than posterior dislocations, accounting for a frequency of 7-13% of all hip dislocations. Neglected anterior hip dislocations are extremely rare, and therefore, there is a paucity of information about the management of these dislocations and associated injuries. The available treatment options for these particular situations are total hip arthroplasty (THA), Girdlestone surgery, or hip arthrodesis.
We describe the case of a 49-year-old male who presented to our hospital with a neglected anterior dislocation of the hip. The patient disclosed a history of hip trauma 8 months ago, initially receiving conservative management. However, due to persistent pain and functional limitations, he sought further medical attention. A physical examination, radiographic evaluation, and computed tomography (CT) scan confirmed the diagnosis. The patient underwent THA using dual anterior and posterior approaches, followed by a comprehensive rehabilitation program.
Anterior dislocation of the hip is a relatively rare condition, and its neglected presentation is even rarer. This case highlights the importance of prompt diagnosis and early intervention in neglected anterior hip dislocations to minimize complications and optimize patient outcomes.
创伤性髋关节脱位常由道路交通事故引起,在发展中国家较为普遍。由于忽视或缺乏恰当治疗而未得到处理的脱位,后续处理会更具挑战性,且发生缺血性坏死(AVN)的可能性增加。随着时间推移,闭合复位方法变得不切实际,如果等待期超过3个月,切开复位同样不可行。前脱位比后脱位少见,占所有髋关节脱位的7% - 13%。被忽视的前髋关节脱位极为罕见,因此,关于这些脱位及其相关损伤的处理信息匮乏。针对这些特殊情况,可用的治疗选择包括全髋关节置换术(THA)、吉德斯顿手术或髋关节融合术。
我们描述了一名49岁男性患者的病例,他因被忽视的前髋关节脱位前来我院就诊。患者透露8个月前有髋关节创伤史,最初接受了保守治疗。然而,由于持续疼痛和功能受限,他寻求进一步治疗。体格检查、影像学评估和计算机断层扫描(CT)证实了诊断。患者采用前后联合双入路接受了全髋关节置换术,随后进行了全面的康复计划。
髋关节前脱位是一种相对罕见的情况,其被忽视的表现更为罕见。本病例强调了对被忽视的前髋关节脱位进行及时诊断和早期干预的重要性,以尽量减少并发症并优化患者预后。