Abstract
Neglected traumatic dislocation of hip in children is very rare and most of the studies are too small to draw a conclusion. There is no consensus on timing for closed VS open reductions and post reduction care. The aim of our prospective study was to analyse and characterise the short term treatment outcome of treating 20 such cases in children (<12 years). All had posterior dislocation without any associated fractures (Thompson & Epstein type 1) sustained during typical childhood play activities and/or a fall from a height less than 10 feet. All attended the hospital between 1-52 weeks of injury. Closed reductions under GA were performed in 12 cases which were less than 3 weeks old, followed by hip immobilisation for 3 weeks and PWB mobilisation for 3 weeks. 8 hips (> 3 weeks old) had open reductions as none of them could be reduced by skeletal tractions and were allowed for FWB mobilisation after 9 weeks. Functional result (Garrett et al) at 2 years follow-up showed a complete range of motion in 18 children while the remaining two had 80% of normal hip movements with no deformity. All the hips showed varying degrees of avascular necrosis, with preservation of joint space on radiographs (Ficat & Arlet stage 1-3). There were no redislocations.
We suggest that closed (for <3 weeks old dislocation) and open (for >3 weeks old dislocations) reductions are satisfactory treatment for traumatic neglected hip dislocations in children
