1/3. Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: a case report.Traumatic anterior dislocation of the hip joint in children is rare, and only one case with ipsilateral femoral fracture has been reported in japan. We report a case of such dislocation and a review of the literature. The patient was a 31-month-old girl who was injured in a car accident while asleep on a tilted front passenger seat. Radiographic examination showed dislocation of the right obturator foramen and transverse fracture of the ipsilateral femoral shaft. The dislocation of the right hip was easily reduced without anaesthesia during radiography. We applied Bryant traction after reduction for 4 weeks, followed by cast application for 3 weeks. walking with support and full weightbearing were permitted 14 weeks and 16 weeks after the injury, respectively. radiography at 4.5 years after the injury showed a mildly enlarged right femoral head and femur overgrowth of approximately 8 mm. magnetic resonance imaging showed no evidence of suspected avascular necrosis of the femoral head. The patient has no subjective or objective symptoms, and is able to engage in all usual activities. The detailed mechanism of the injury is unknown. We assume that the lower leg was dislocated through abduction during flexion, or abducent, external flexion, considering that the child was sleeping at the time of the accident. Since she was hurled to the back seat, it was assumed that strong external force was vertically added to the femur, which caused the abducent force.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Traumatic dislocation of the hip in young children.Traumatic dislocation of the hip joint is an uncommon injury in children. The present report on this traumatic emergency is based on the authors' own observations of three cases and a review of the literature. The main problem is the possible development of avascular necrosis of the femoral head. The crucial therapeutic intervention to avoid this serious complication seems to be immediate, usually closed, reduction under general anaesthesia. A management protocol is presented.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/3. Traumatic dislocation of the hip in adolescence with separation of the capital epiphysis. Two case reports.Fracture separation of the capital femoral epiphysis occurring during attempted closed reduction of a traumatic dislocation of the hip is described in two adolescents. Although this complication is extremely rare, the prognosis of fracture separation with dislocation of the epiphysis is known to be poor. Avascular necrosis subsequently developed in both cases. The importance of gentle manipulative reduction under general anaesthesia with complete muscle relaxation is emphasised.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |