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Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report
G Model
ARCPED-4756; No. of Pages 4 Archives de Pe´diatrie xxx (2019) xxx–xxx
Available online at
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Short communication
Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report M.A. Khalifa a, Z. Alaya b,*, L. Hassini a, K. Bouattour a, W. Osman a, M.L. Ben Aye`che a a b
Department of Orthopeadics, Sahloul Hospital, Faculty of Medicine of Sousse, Ibn El Jazzar Street, 4000, Sousse, Tunisia Departement of Internal Medicine, Mohamed Taher Maamouri Hospital, 8000 Nabeul, Tunisia
A R T I C L E I N F O
A B S T R A C T
Article history: Received 8 April 2019 Received in revised form 4 August 2019 Accepted 20 September 2019 Available online xxx
Approximately 3% of all joint dislocations involve the hip joint, and only 8–10% of these will be anterior. Traumatic anterior open dislocation of the hip is rare in children and prone to be associated with injuries, extensive soft tissue damage, and avascular necrosis of the femoral head. We present a case of a 13-yearold boy who had an open anterior dislocation of the hip with ipsilateral avulsion of the greater trochanter after a tractor wheel crush in an agricultural accident. Additional lesions included a diaphyseal closed fracture of the contralateral femur. We report this case because of the rarity and seriousness of this injury due to its progressive complications and difficulties related to its management.
C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
Keywords: Anterior Traumatic Hip dislocation Greater trochanter
1. Introduction The hip joint is inherently stable, which requires significant force to promote its dislocation. Therefore, hip dislocations usually result from high-energy trauma. Craniocerebral, thoracic, and abdominal injuries are commonly associated. Skeletal injuries often associated include fractures of the head or femoral neck, femoral shaft, acetabulum, and pelvis, as well as knee, ankle, and foot injuries and neurological lesions [1]. Approximately 3% of all joint dislocations involve the hip joint, and only 8–10% of these will be anterior. Open traumatic dislocation of the hip is rare and even unusual in children. Early recognition and prompt, congruous reduction is advised [2]. We report an adolescent who sustained an open anterior dislocation of the hip with ipsilateral avulsion of the greater trochanter.
2. Case presentation We present a case of a 13-year-old boy who had an open anterior dislocation of the hip with ipsilateral avulsion fracture of the greater trochanter and a diaphyseal closed fracture of the contralateral femur after a tractor wheel crush in an agricultural * Corresponding author. E-mail address: [email protected] (Z. Alaya).
accident. Additional lesions included thoracic trauma with rib fractures and pneumothorax. The physical examination revealed a protrusion of the right femoral head through an 12-cm-long inguinal wound without vascular/nerve complications. The femoral head was clearly visible in the inguinal region (Fig. 1). The radiographic examination and the CT scan (Fig. 2, Fig. 3) revealed anterior dislocation of the right hip associated with an avulsion fracture of the ipsilateral greater trochanter and a diaphyseal fracture of the contralateral femur. The wound was cleaned and debrided under general anesthesia. Then the right hip was easily reduced with longitudinal traction and internal rotation of the lower extremity (Fig. 4). The wound was closed over a vacuum drain with introduction of broadspectrum antibiotics for 7 days. The left shaft femoral fracture was treated with open reduction and internal fixation by plate and screw. Postoperative x-ray showed proper reduction in the right hip dislocation and greater trochanter. After surgery, the patient was admitted to the intensive care unit for 2 weeks before leaving the hospital. The patient was followed up regularly, the wound healed satisfactorily with no evidence of infection, nor any episode of redislocation. After 3 years of follow-up, the functional outcome was poor, with limited range of motion of the hip (flexion 1008, extension 108, abduction 208, adduction 108, internal rotation 208, external rotation 308). An anteroposterior x-ray showed the right hip congruency with periarticular ossification at 1 year postoper-
https://doi.org/10.1016/j.arcped.2019.09.005 C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved. 0929-693X/
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
G Model
ARCPED-4756; No. of Pages 4 M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
2
Fig. 1. Appearance of wound at the root of the right thigh, exposing the femoral head.
Fig. 3. Pelvic computed tomography showing the anterior and superior dislocation of the right hip with trochanteric ipsilateral fracture.
Fig. 2. AP radiograph of the pelvis demonstrating the anterior and superior dislocation of the right hip with trochanteric ipsilateral fracture, and the diaphyseal fracture of the left femur. Fig. 4. Postoperative x-ray of proper reduction in the right hip dislocation and right greater trochanter.
ative (Fig. 5) and advanced osteonecrosis at 3 years postoperative (Fig. 6). A replacement hip prosthesis was placed when the patient was 18 years old (Fig. 7). The functional result at the last follow-up at 3 years was very good with total indolence, stable walking, and good hip mobility (flexion 1208, extension 08, abduction 408, adduction 308, internal rotation 308, external rotation 408). The PMA score was 17. Moreover, the patient retained a 2-cm length discrepancy compensated by a compensation insole.
3. Discussion Traumatic hip dislocation in children is a relatively rare injury accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type, but the much rarer anterior type has also been described, accounting for about 5–10% of all pediatric hip dislocations [3,4]. Holzach et al. reported 86 patients with traumatic hip dislocation, of whom 78 had a posterior dislocation, five anterior, and three central [5]. Further studies consisting of more than 100 cases have revealed the incidence of traumatic dislocation of the hip in children ranging from 0.6 to 11.1% [6]. In reports of dislocation of the hip in children,
Fig. 5. One-year postoperative anteroposterior x-ray view of the right hip congruency with periarticular ossification.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
G Model
ARCPED-4756; No. of Pages 4 M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
Fig. 6. Pelvic plain radiography showed advanced osteonecrosis on the right hip at 3 years postoperatively.
3
In our case, open hip dislocation was associated with an epiphyseal fracture-dislocated ipsilateral greater trochanter and a diaphyseal fracture of the contralateral femur, which is probably the first such case reported in the literature. The absence of associated acetabular fracture even though the trauma was violent enough to cause an inguinal skin wound is another unusual aspect of this case. The absence of acetabular fracture can be explained by excessive and almost instantaneous external rotation, which would not have given any time for the head of the femur to cause an impact on the wall and thus fracture the wall, resulting in a trochanteric fracture through the application of lateral forces by impact on the hip bone. Reduction within 6 h is recommended to minimize the risk of osteonecrosis [4]. Mehlman et al. [14] and Kutty et al. [15] noted a 20-fold increase in osteonecrosis when reduction was delayed beyond 6 h in children and adolescents. Herrera and Price pointed out that early diagnosis and treatment will reduce the risk of osteonecrosis. When open reduction is required, the surgical approach should be from the direction of dislocation [4]. Although up to 3 mm of hip joint asymmetry may be attributable to hematoma or joint laxity, one should not assume that either is the cause of minor asymmetry. An entrapped labrum or torn ligamentous teres or loose osteocartilaginous fragment can also lead to incomplete reduction [16]. The sequelae after traumatic hip dislocation comprise a long list: osteonecrosis (3–15%), irreducible dislocation, recurrent dislocation, osteoarthritis, and neurological injury (5%). Other late complications include coxa magna, heterotopic bone formation, and premature closure of the triradiate [4,6]. In spite of relatively easy reduction within 4 h of injury, our case developed avascular necrosis, which was treated with a total hip replacement with a very good functional and radiological result at the last follow-up. 4. Conclusion
Fig. 7. Pelvic plain right hip x-ray.
the rate of anterior dislocation ranged from 7.5 to 17.8% [7]. Traumatic dislocation of the hip joint is uncommon in children and is usually seen in the preadolescent age group between 7 and 10 years [8]. Engelbrecht and Grabe reported that traumatic dislocation of pediatric patients’ hip accounted for 0.335% of the injuries seen in their unit [9]. Anterior dislocations result from forced abduction and external rotation. Epstein and Harvey have classified them into two types. In the extension type or pubic type, the hip dislocates anteriorly and superiorly. The limb appears short, and the thigh is extended and externally rotated with the femoral head palpable in the groin. In the more common flexion or obturator type, the femoral head dislocates inferiorly, and the limb is abducted and externally rotated with femoral head palpable near the obturator foramen [10]. Open hip dislocation remains a rare occurrence due to the bulky muscle envelope surrounding the deeply situated hip. Review of the literature brought out only 15 cases of open anterior dislocation of the hip to date; of which eight cases were observed in adults and seven cases were observed in children in addition to our case, which would probably be the eighth case [11]. In all of them immediate reduction and adequate debridement with antibiotic coverage was carried out and the patients had an uneventful recovery [12]. Anterior hip dislocations can be associated with femoral neurovascular injury, femoral head fractures, and acetabular fractures [2,13]. These injuries are associated with a poorer prognosis as well as with a delay in joint reduction.
Anterior traumatic open dislocation of the hip is very rare. It occurs in the context of high-velocity polytrauma. There are various associated lesions. An open dislocation is possible even in the absence of an acetabular fracture. The long-term prognosis depends on the occurrence of complications, mainly avascular necrosis of femoral head, which is very difficult to manage, especially in children and adolescents. To reduce the risk of occurrence of femoral head necrosis, reduction and repair of the associated lesions must be performed as quickly as possible. Disclosure of interest The authors declare that they have no competing interest.
References [1] Tornetta 3rd P. Hip dislocations and fractures of the femoral head. In: Bucholz RW, Heckman JD, Court-Brown CM, editors. Rockwood & Green’s fractures in adults. 6th ed, Philadelphia: Lippincott, Williams and Wilkins; 2006. p. 1716–52. [2] Rafai M, Ouarab M, Largab A, et al. Open post-traumatic anterior luxation of the hip in children. Apropos of a case and review of the literature. Rev Chir Orthop Reparatrice Appar Mot 1995;81:178–81. [3] Vialle R, Odent T, Pannier S, et al. Traumatic hip dislocation in childhood. J Pediatr Orthop 2005;25:138–44. [4] Herrera-Soto JA, Price CT. Traumatic hip dislocations in children and adolescent: pitfalls and complications. J Am Acad Orthop Surg 2009;17:15–21. [5] Holzach P, Weymann A, Perren T, et al. Traumatic hip dislocations. Epidemiologic data at Davos Hospital and a multicenter study in Graubunden Canton. Z Unfallchir Versicherungsmed Suppl 1993;1:187–93. [6] Zekry M, Mahmoodi MS, Saad G, et al. Traumatic anterior dislocation of hip in a teenager: an open unusual type. Eur J Orthop Surg Traumatol 2012;22(Suppl. 1):99–101. [7] Yamamoto K, Ko M, Masaoka T, et al. Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: a case report. J Orthop Surg 2004;12:126–32. [8] Haugaaod K, Thonsen PB. Traumatic hip dislocation in children. Follow up of 13 cases. Orthopaedics 1989;12:375–8.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
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ARCPED-4756; No. of Pages 4 4
M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
[9] Engelbrecht PR, Grabe RP. Traumatic dislocation of the hip in children. A report of 4 cases. S Afr J Surg 1992;30:175–7. [10] Epstein HC, Harvey JP. Traumatic anterior dislocation of hip. Management and results. J Bone Joint Surg [Am] 1972;54:1561–2. [11] De Oliveira AL, Machado EG. Open anterior dislocation of the hip in an adult: a case report and review of literature. Rev Bras Ortop 2014;49:94–7. [12] Muzaffar N, Hafeez A, Bashir N, et al. Open anterior hip dislocation in a young adult with exposed femoral head and no neurovascular damage. Malays Orthop J 2012;6:40–2.
[13] Khan SA, Sadiq SA, Abbas M, et al. Open anterior dislocation of the hip in a child. J Trauma 2001;51:773–6. [14] Mehlman CT, Hubbard GW, Crawford AH, et al. Traumatic hip dislocation in children: long term follow up of 42 patients. Clin Orthop Relat Res 2000;376:68–79. [15] Kutty S, Thornes B, Curtin WA, et al. Traumatic posterior dislocation in children. Paediatr Emerg Care 2001;17:32–5. [16] Vialle R, Pannier S, Odent T, et al. Imaging of traumatic dislocation of the hip in childhood. Pediatr Radiol 2004;34:970–9.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
ARCPED-4756; No. of Pages 4 Archives de Pe´diatrie xxx (2019) xxx–xxx
Available online at
ScienceDirect www.sciencedirect.com
Short communication
Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report M.A. Khalifa a, Z. Alaya b,*, L. Hassini a, K. Bouattour a, W. Osman a, M.L. Ben Aye`che a a b
Department of Orthopeadics, Sahloul Hospital, Faculty of Medicine of Sousse, Ibn El Jazzar Street, 4000, Sousse, Tunisia Departement of Internal Medicine, Mohamed Taher Maamouri Hospital, 8000 Nabeul, Tunisia
A R T I C L E I N F O
A B S T R A C T
Article history: Received 8 April 2019 Received in revised form 4 August 2019 Accepted 20 September 2019 Available online xxx
Approximately 3% of all joint dislocations involve the hip joint, and only 8–10% of these will be anterior. Traumatic anterior open dislocation of the hip is rare in children and prone to be associated with injuries, extensive soft tissue damage, and avascular necrosis of the femoral head. We present a case of a 13-yearold boy who had an open anterior dislocation of the hip with ipsilateral avulsion of the greater trochanter after a tractor wheel crush in an agricultural accident. Additional lesions included a diaphyseal closed fracture of the contralateral femur. We report this case because of the rarity and seriousness of this injury due to its progressive complications and difficulties related to its management.
C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
Keywords: Anterior Traumatic Hip dislocation Greater trochanter
1. Introduction The hip joint is inherently stable, which requires significant force to promote its dislocation. Therefore, hip dislocations usually result from high-energy trauma. Craniocerebral, thoracic, and abdominal injuries are commonly associated. Skeletal injuries often associated include fractures of the head or femoral neck, femoral shaft, acetabulum, and pelvis, as well as knee, ankle, and foot injuries and neurological lesions [1]. Approximately 3% of all joint dislocations involve the hip joint, and only 8–10% of these will be anterior. Open traumatic dislocation of the hip is rare and even unusual in children. Early recognition and prompt, congruous reduction is advised [2]. We report an adolescent who sustained an open anterior dislocation of the hip with ipsilateral avulsion of the greater trochanter.
2. Case presentation We present a case of a 13-year-old boy who had an open anterior dislocation of the hip with ipsilateral avulsion fracture of the greater trochanter and a diaphyseal closed fracture of the contralateral femur after a tractor wheel crush in an agricultural * Corresponding author. E-mail address: [email protected] (Z. Alaya).
accident. Additional lesions included thoracic trauma with rib fractures and pneumothorax. The physical examination revealed a protrusion of the right femoral head through an 12-cm-long inguinal wound without vascular/nerve complications. The femoral head was clearly visible in the inguinal region (Fig. 1). The radiographic examination and the CT scan (Fig. 2, Fig. 3) revealed anterior dislocation of the right hip associated with an avulsion fracture of the ipsilateral greater trochanter and a diaphyseal fracture of the contralateral femur. The wound was cleaned and debrided under general anesthesia. Then the right hip was easily reduced with longitudinal traction and internal rotation of the lower extremity (Fig. 4). The wound was closed over a vacuum drain with introduction of broadspectrum antibiotics for 7 days. The left shaft femoral fracture was treated with open reduction and internal fixation by plate and screw. Postoperative x-ray showed proper reduction in the right hip dislocation and greater trochanter. After surgery, the patient was admitted to the intensive care unit for 2 weeks before leaving the hospital. The patient was followed up regularly, the wound healed satisfactorily with no evidence of infection, nor any episode of redislocation. After 3 years of follow-up, the functional outcome was poor, with limited range of motion of the hip (flexion 1008, extension 108, abduction 208, adduction 108, internal rotation 208, external rotation 308). An anteroposterior x-ray showed the right hip congruency with periarticular ossification at 1 year postoper-
https://doi.org/10.1016/j.arcped.2019.09.005 C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved. 0929-693X/
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
G Model
ARCPED-4756; No. of Pages 4 M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
2
Fig. 1. Appearance of wound at the root of the right thigh, exposing the femoral head.
Fig. 3. Pelvic computed tomography showing the anterior and superior dislocation of the right hip with trochanteric ipsilateral fracture.
Fig. 2. AP radiograph of the pelvis demonstrating the anterior and superior dislocation of the right hip with trochanteric ipsilateral fracture, and the diaphyseal fracture of the left femur. Fig. 4. Postoperative x-ray of proper reduction in the right hip dislocation and right greater trochanter.
ative (Fig. 5) and advanced osteonecrosis at 3 years postoperative (Fig. 6). A replacement hip prosthesis was placed when the patient was 18 years old (Fig. 7). The functional result at the last follow-up at 3 years was very good with total indolence, stable walking, and good hip mobility (flexion 1208, extension 08, abduction 408, adduction 308, internal rotation 308, external rotation 408). The PMA score was 17. Moreover, the patient retained a 2-cm length discrepancy compensated by a compensation insole.
3. Discussion Traumatic hip dislocation in children is a relatively rare injury accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type, but the much rarer anterior type has also been described, accounting for about 5–10% of all pediatric hip dislocations [3,4]. Holzach et al. reported 86 patients with traumatic hip dislocation, of whom 78 had a posterior dislocation, five anterior, and three central [5]. Further studies consisting of more than 100 cases have revealed the incidence of traumatic dislocation of the hip in children ranging from 0.6 to 11.1% [6]. In reports of dislocation of the hip in children,
Fig. 5. One-year postoperative anteroposterior x-ray view of the right hip congruency with periarticular ossification.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
G Model
ARCPED-4756; No. of Pages 4 M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
Fig. 6. Pelvic plain radiography showed advanced osteonecrosis on the right hip at 3 years postoperatively.
3
In our case, open hip dislocation was associated with an epiphyseal fracture-dislocated ipsilateral greater trochanter and a diaphyseal fracture of the contralateral femur, which is probably the first such case reported in the literature. The absence of associated acetabular fracture even though the trauma was violent enough to cause an inguinal skin wound is another unusual aspect of this case. The absence of acetabular fracture can be explained by excessive and almost instantaneous external rotation, which would not have given any time for the head of the femur to cause an impact on the wall and thus fracture the wall, resulting in a trochanteric fracture through the application of lateral forces by impact on the hip bone. Reduction within 6 h is recommended to minimize the risk of osteonecrosis [4]. Mehlman et al. [14] and Kutty et al. [15] noted a 20-fold increase in osteonecrosis when reduction was delayed beyond 6 h in children and adolescents. Herrera and Price pointed out that early diagnosis and treatment will reduce the risk of osteonecrosis. When open reduction is required, the surgical approach should be from the direction of dislocation [4]. Although up to 3 mm of hip joint asymmetry may be attributable to hematoma or joint laxity, one should not assume that either is the cause of minor asymmetry. An entrapped labrum or torn ligamentous teres or loose osteocartilaginous fragment can also lead to incomplete reduction [16]. The sequelae after traumatic hip dislocation comprise a long list: osteonecrosis (3–15%), irreducible dislocation, recurrent dislocation, osteoarthritis, and neurological injury (5%). Other late complications include coxa magna, heterotopic bone formation, and premature closure of the triradiate [4,6]. In spite of relatively easy reduction within 4 h of injury, our case developed avascular necrosis, which was treated with a total hip replacement with a very good functional and radiological result at the last follow-up. 4. Conclusion
Fig. 7. Pelvic plain right hip x-ray.
the rate of anterior dislocation ranged from 7.5 to 17.8% [7]. Traumatic dislocation of the hip joint is uncommon in children and is usually seen in the preadolescent age group between 7 and 10 years [8]. Engelbrecht and Grabe reported that traumatic dislocation of pediatric patients’ hip accounted for 0.335% of the injuries seen in their unit [9]. Anterior dislocations result from forced abduction and external rotation. Epstein and Harvey have classified them into two types. In the extension type or pubic type, the hip dislocates anteriorly and superiorly. The limb appears short, and the thigh is extended and externally rotated with the femoral head palpable in the groin. In the more common flexion or obturator type, the femoral head dislocates inferiorly, and the limb is abducted and externally rotated with femoral head palpable near the obturator foramen [10]. Open hip dislocation remains a rare occurrence due to the bulky muscle envelope surrounding the deeply situated hip. Review of the literature brought out only 15 cases of open anterior dislocation of the hip to date; of which eight cases were observed in adults and seven cases were observed in children in addition to our case, which would probably be the eighth case [11]. In all of them immediate reduction and adequate debridement with antibiotic coverage was carried out and the patients had an uneventful recovery [12]. Anterior hip dislocations can be associated with femoral neurovascular injury, femoral head fractures, and acetabular fractures [2,13]. These injuries are associated with a poorer prognosis as well as with a delay in joint reduction.
Anterior traumatic open dislocation of the hip is very rare. It occurs in the context of high-velocity polytrauma. There are various associated lesions. An open dislocation is possible even in the absence of an acetabular fracture. The long-term prognosis depends on the occurrence of complications, mainly avascular necrosis of femoral head, which is very difficult to manage, especially in children and adolescents. To reduce the risk of occurrence of femoral head necrosis, reduction and repair of the associated lesions must be performed as quickly as possible. Disclosure of interest The authors declare that they have no competing interest.
References [1] Tornetta 3rd P. Hip dislocations and fractures of the femoral head. In: Bucholz RW, Heckman JD, Court-Brown CM, editors. Rockwood & Green’s fractures in adults. 6th ed, Philadelphia: Lippincott, Williams and Wilkins; 2006. p. 1716–52. [2] Rafai M, Ouarab M, Largab A, et al. Open post-traumatic anterior luxation of the hip in children. Apropos of a case and review of the literature. Rev Chir Orthop Reparatrice Appar Mot 1995;81:178–81. [3] Vialle R, Odent T, Pannier S, et al. Traumatic hip dislocation in childhood. J Pediatr Orthop 2005;25:138–44. [4] Herrera-Soto JA, Price CT. Traumatic hip dislocations in children and adolescent: pitfalls and complications. J Am Acad Orthop Surg 2009;17:15–21. [5] Holzach P, Weymann A, Perren T, et al. Traumatic hip dislocations. Epidemiologic data at Davos Hospital and a multicenter study in Graubunden Canton. Z Unfallchir Versicherungsmed Suppl 1993;1:187–93. [6] Zekry M, Mahmoodi MS, Saad G, et al. Traumatic anterior dislocation of hip in a teenager: an open unusual type. Eur J Orthop Surg Traumatol 2012;22(Suppl. 1):99–101. [7] Yamamoto K, Ko M, Masaoka T, et al. Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: a case report. J Orthop Surg 2004;12:126–32. [8] Haugaaod K, Thonsen PB. Traumatic hip dislocation in children. Follow up of 13 cases. Orthopaedics 1989;12:375–8.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005
G Model
ARCPED-4756; No. of Pages 4 4
M.A. Khalifa et al. / Archives de Pe´diatrie xxx (2019) xxx–xxx
[9] Engelbrecht PR, Grabe RP. Traumatic dislocation of the hip in children. A report of 4 cases. S Afr J Surg 1992;30:175–7. [10] Epstein HC, Harvey JP. Traumatic anterior dislocation of hip. Management and results. J Bone Joint Surg [Am] 1972;54:1561–2. [11] De Oliveira AL, Machado EG. Open anterior dislocation of the hip in an adult: a case report and review of literature. Rev Bras Ortop 2014;49:94–7. [12] Muzaffar N, Hafeez A, Bashir N, et al. Open anterior hip dislocation in a young adult with exposed femoral head and no neurovascular damage. Malays Orthop J 2012;6:40–2.
[13] Khan SA, Sadiq SA, Abbas M, et al. Open anterior dislocation of the hip in a child. J Trauma 2001;51:773–6. [14] Mehlman CT, Hubbard GW, Crawford AH, et al. Traumatic hip dislocation in children: long term follow up of 42 patients. Clin Orthop Relat Res 2000;376:68–79. [15] Kutty S, Thornes B, Curtin WA, et al. Traumatic posterior dislocation in children. Paediatr Emerg Care 2001;17:32–5. [16] Vialle R, Pannier S, Odent T, et al. Imaging of traumatic dislocation of the hip in childhood. Pediatr Radiol 2004;34:970–9.
Please cite this article in press as: Khalifa MA, et al. Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report. Archives de Pe´diatrie (2019), https://doi.org/10.1016/j.arcped.2019.09.005