Hip dislocation in a 3-year old girl after minor trauma: A rare case report

TL;DR

A 3-year-old girl suffered a rare hip dislocation after a minor injury and was successfully treated with emergency reduction and a cast.

Contribution

This case report highlights the management of a rare pediatric hip dislocation following low-energy trauma.

Findings

The patient presented with posterior hip dislocation after a twisting injury.

Emergency closed reduction and casting led to normal clinical and radiographic outcomes at 8 months.

Prompt treatment is essential to avoid complications like avascular necrosis.

Abstract

Traumatic hip dislocations in children are rare injuries. They are mostly sustained after low-energy trauma in younger children, and after high-energy trauma in older children and adolescents. In 90 % of cases dislocation is posterior. Since this condition is an orthopedic emergency, it requires urgent reduction in order to avoid complications such as recurrent or habitual dislocation or avascular necrosis (AVN) of the femoral head.

A 3-year old girl presented sustained posterior dislocation of the right hip after twisting injury. Clinically, the right leg was shortened, and in the position of adduction, with limited passive motion of the right hip joint. Plain pelvis X-ray revealed right hip joint dislocation. Emergency closed reduction was made after sedation by Allis maneuver, and one and a half hip spica cast was applied. After three weeks, the cast was removed and patients referred to physical therapy with allowed weight-bearing on the injured leg. At 8-month follow-up, clinical and radiographic findings were normal.

Careful evaluation, complete history, thorough clinical exam and imaging are required in rare cases of pediatric traumatic hip joint dislocation, with prompt closed reduction, in order to achieve favorable clinical outcomes.

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