Published online May 16, 2018. doi: 10.12998/wjcc.v6.i5.94
Peer-review started: February 13, 2018
First decision: March 8, 2018
Revised: April 1, 2018
Accepted: April 16, 2018
Article in press: April 17, 2018
Published online: May 16, 2018
Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. Only 33 cases have been previously reported in the English language literature. Although they were all due to high-energy injuries, they were hemodynamically stable and had a stable pelvic ring. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. A 40-year-old man was injured in a high-energy motor vehicle accident. He was hemodynamically unstable when he presented in the emergency department. Radiolographs showed asymmetrical dislocations of both hips with an unstable pelvic ring. Under general anesthesia, he had closed reduction of the dislocations of both hips, followed by temporary stabilization with an external fixator. Transcatheter arterial embolization was performed to stop active pelvic bleeding. Delayed open reduction and internal fixation was performed 12 d later with anterior and posterior plates. The patient recovered well with an uneventful post-operative course. Asymmetrical bilateral hip dislocations with pelvic ring instability caused by trauma, as presented in this case, is very rare and potentially life threatening. Prompt treatment can give a good outcome.
Core tip: Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. Given the severity of the associated complications, every effort should be made to ensure prompt diagnosis and immediate therapy. Attention must be paid to early rescue procedures, including initial circulation support and elimination of bleeding, as well as joint reduction and rapid stabilization of the pelvic ring.