Vol 43 # 3 September 2011 - Kma.org.kw

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Traumatic Anterior Hip Dislocation (Perineal) with Ipsilateral Avulsion Fracture ...
September 2011
Fig. 2: Anteroposterior (a) and lateral (b) radiographs of the right hip four months after injury, presenting healed avulsed fractures of the
greater and lesser trochanter and viable head of the right femur
Early diagnosis and treatment of the dislocation
decrease the incidence. Delay in reduction (more than
six hours), repeated attempts at closed reduction, open
reduction, severity of the injury, presence of fracture
dislocation, and age above five years are the most
important factors implicated in the development of
avascular necrosis [8,9,19,20] . The lowest incidence occurs
in children under five years of age [9] . The recommended
non-weight bearing period varies from four to six
weeks [21] to as much as four months after reduction of
the dislocation [15] . Several authors have documented
that a prolonged non-weight bearing period does not
significantly influence the development of the femoral
head necrosis [22,23] .
We assume that the decisive factor in the
development of avascular necrosis in our patient
was the severity of the injury, as the dislocation was
perineal, with an additional avulsion fracture of the
Fig. 3: Avascular necrosis of the right femoral head eight months after the injury, seen on anteroposterior (a) and lateral (b) radiographs