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Traumatic Hip Dislocations in Children and Adolescents: Pitfalls and Complications

Herrera-Soto, José A. MD; Price, Charles T. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 2009 - Volume 17 - Issue 1 - p 15–21

Traumatic hip dislocation is an uncommon injury in children. Lack of familiarity with management of the treating physician may lead to complications. Hip dislocation in young children can occur with minor trauma; in adolescents, greater force is required to produce a traumatic complete hip dislocation. Transient hip dislocation with spontaneous but incomplete reduction is a diagnostic pitfall that can occur in adolescents. Any asymmetric widening of the hip joint warrants additional investigation. Most dislocations in children can be reduced with gentle manipulation. Urgent reduction of the hip within 6 hours of injury reduces the risk of osteonecrosis. However, closed reduction in adolescents should be performed with caution because of the risk of displacement of the femoral head during manipulation. Open reduction is indicated when closed reduction fails or when there is interposition of bone or soft tissue following attempted closed reduction. Late complications include osteonecrosis, coxa magna, and osteoarthritis.

Dr. Herrera-Soto is Assistant Program Director, Pediatric Orthopaedic Fellowship Program and Director of Orthopaedic Research, Orlando Regional Medical Center, Orlando, FL. Dr. Price is Program Director, Pediatric Orthopaedic Fellowship, Orlando Regional Medical Center.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Herrera-Soto and Dr. Price.

Reprint requests: Dr. Herrera-Soto, Pediatric Orthopaedic Fellowship Program, Orlando Regional Medical Center, 83 West Columbia Street, Orlando, FL 32806.

© 2009 by American Academy of Orthopaedic Surgeons
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