Traumatic bilateral posterior hip dislocation in children. A 12 years follow up case report

Abstract

Background. Bilateral traumatic hip dislocation in children is a very rare orthopedic emergency. Few case reports are available in literature. Clinical case. A 4-year-old male child case with a trivial mechanism of injury is presented. Closed reduction in emergency department was achieved after 24 hours of injury, he was placed on Bucks skin traction for 4 days and during 4 weeks in a spica cast. There was not either clinical sign nor images of early or late complications during follow up until he reached skeletal maturity. Discussion. Hip dislocation in children is a rare emergency with an incidence of 0.8 cases per million per year, its treatment should not be delayed to minimize late complications such as osteonecrosis, recurrent dislocations, osteoarthritis, neurological lesions, coxa magna and heterotopic ossification. The reported incidence for hip osteonecrosis is 36.4% for late (6 hours) and 8.2% after early (6 hours) reduction. After 12 years of follow up no complication was found although the reduction was made 24 hours later. Conclusions. After immediate reduction a 4 to 6 weeks immobilization period is an effective treatment. Close monitoring to timely identify and treat any further complication is mandatory.