Traumatic Bilateral Asymmetrical Hip Dislocation with Acetabular Fracture: A Case Report and Review of Current Evidence

TL;DR

A rare case of traumatic bilateral asymmetrical hip dislocation with acetabular fracture is reported, highlighting successful treatment and recovery strategies.

Contribution

This case report adds to the limited literature on bilateral asymmetrical hip dislocations and emphasizes the importance of early intervention and individualized rehabilitation.

Findings

Successful closed reduction followed by surgical stabilization led to full recovery without avascular necrosis or osteoarthritis.

Early reduction within six hours and timely surgical intervention are critical for favorable outcomes.

Individualized rehabilitation protocols are essential for recovery from complex hip dislocations.

Abstract

Bilateral asymmetrical hip dislocations are rare, occurring in only 0.01–0.02% of all joint dislocations, typically following high-energy trauma. We present a 22-year-old male involved in a high-speed motor vehicle collision, sustaining a right posterior hip dislocation with an associated posterior wall acetabular fracture and a left obturator-type anterior dislocation. He underwent successful closed reduction within two hours post-injury, but due to persistent instability of the posterior acetabular wall fracture, open reduction and internal fixation (ORIF) via a Kocher–Langenbeck approach was performed. A structured rehabilitation protocol facilitated full functional recovery at six months, with no evidence of avascular necrosis (AVN) or post-traumatic osteoarthritis. A literature review of relevant studies highlights the importance of early reduction (<6 h) to reduce AVN risk, timely surgical stabilization for acetabular fractures, and individualized rehabilitation strategies. While our case supports established treatment guidelines, long-term outcomes and optimal rehabilitation protocols remain areas for further research. Expedited diagnosis, early intervention, and evidence-based management are essential in achieving favorable outcomes for these complex injuries.

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