DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20214972
Published: 2021-12-24

Restoration of neglected fracture dislocation hip in elderly: a case report

Praveen Raj, Kaustav Mukherjee, Gokul Raj Dhanrajan, Sundararaja Bhaskar, Pradeep Jayaram Purushothaman

Abstract


Neglected traumatic fracture dislocation of the hip is a challenging problem due to soft tissue contractures, adhesions, fibro fatty tissue filling acetabulum, avascular necrosis, arthritis and myositis ossificans. These types of injury often get missed at initial evaluation in the presence of distracting injuries and in poly trauma patients. Femoral head fractures account for only 7-16% of all hip fracture dislocations, with combined femoral head and acetabular fractures in elderly being even lower. Literature favours primary hip replacement as compared to hip salvage in age above 60 years and in patients with neglected hip fracture dislocations of more than 3 months duration due to high chances of afore mentioned complications. Here, we report a case of 69 years old male with neglected hip fracture dislocation associated with posterior acetabular wall and femoral head fracture for the challenges in management with a total hip replacement.


Keywords


Neglected, Hip fracture dislocation, Femoral head fracture, Total hip replacement

Full Text:

PDF

References


Hougaard K, Thomsen PB. Traumatic posterior dislocation of the hip—prognostic factors influencing the incidence of avascular necrosis of the femoral head. Archives of orthopaedic and traumatic surgery. 1986;106(1):32-5.

Goyal R, Bhavsar NM, Goel A, Bhatia N, Mehndiratta A, Goel SA. Neglected Two-Week-Old Unstable Fracture-Dislocation of the Hip in a 60 Years Old, Managed with Hip Preservation Surgery. Journal of Orthopaedic Case Reports. 2020;10(4):38.

Epstein HC, Wiss DA, Cozen LE. Posterior fracture dislocation of the hip with fractures of the femoral head. Clinical orthopaedics and related research. 1985;201:9-17.

Kiran S, Sodagor S, Buragohain CR. Neglected posterior hip dislocation: management of an 18 years old female. Int J Health Res Medico Leg Prae. 2020;6(2):52-5.

Pugalenthi PV, Ramanathan S, Thanappan N, Sagar MV. A rare case of neglected unreduced posterior dislocation of hip managed with total hip arthroplasty-a case report. J Evol Med Dent Sci. 2017;6:1953-7.

Guimaraes RP, de Souza GS, da Silva Reginaldo S, Ono NK, Honda Ek et al. Study of the treatment of femoral head fractures. RevistaBrasileira de Ortopedia (English Edition). 2010;45(4):355-61.

Gänsslen A, Grechenig S, Nerlich M, Müller M, Grechenig W, Lindahl J. Standard approaches to the acetabulum part 3: intrapelvic approach. Acta ChirOrthopTraumatol Cech. 2016;83(5):293-9.

Garrett JC, Epstein HC, Harris WH, Harvey Jr JP, Nickel VL. Treatment of unreduced traumatic posterior dislocations of the hip. The Journal of bone and joint surgery. American volume. 1979;61(1):2-6.

Banskota AK, Spiegel DA, Shrestha S, Shrestha OP, Rajbhandary T. Open reduction for neglected traumatic hip dislocation in children and adolescents. Journal of Pediatric Orthopaedics. 2007;27(2):187-91.

Pai VS, Kumar B. Management of unreduced traumatic posterior dislocation of the hip: heavy traction and abduction method. Injury. 1990;21(4):225-7.

Patel S, Thimmegowda RB, John R, Kumar TS, Arjun RH. Total hip arthroplasty in neglected, obturator type, hip dislocation in a young adult–an unusual case and literature review. Journal of Arthroscopy and Joint Surgery. 2017;4(1):50-3.

Kumar S, Dahuja A, Narula MS, Garg S, Kaur R. Neglected hip dislocation: an unusual presentation, its management and review of the literature. Strategies in trauma and limb reconstruction. 2017;12(3):189-92.-100.