Bilateral Asymmetrical Hip Dislocations after Falling from Height: A Case Report and Literature Review

Omid Kohandel; Mohammad Sajjad Mirhoseini; Seyede Sanaz Mirrahimi

doi:10.18502/jost.v10i2.15519

Omid Kohandel General Practitioner, Madani Clinical Research Development Unit, Alborz University of Medical Sciences, Karaj, Iran
Mohammad Sajjad Mirhoseini Assistant Professor, Madani Clinical Research Development Unit, Alborz University of Medical Sciences, Karaj, Iran
Seyede Sanaz Mirrahimi BSc Student in Operating Room, Student Research Committee, School of Paramedical Science, Alborz University of Medical Sciences, Karaj, Iran

DOI: https://doi.org/10.18502/jost.v10i2.15519

Keywords: Hip Dislocation; Hip Joint; Closed Fracture Reduction

Abstract

Background: Hip dislocations, constituting 2-5 percent of all joint dislocations, predominantly present as posterior dislocations. Bilateral hip dislocations are rare, accounting for 1.25% of cases. Associated fractures often involve the proximal femur and acetabulum.

Case Report: A 60-year-old man with no prior hip trauma history sustained bilateral hip dislocations after a 6-meter fall. Initial assessments and a hip computed tomography (CT) scan confirmed posterior dislocation of the right hip and anterior dislocation of the left hip. The patient underwent a successful closed pelvic reduction operation four hours post-injury, as confirmed by a post-reduction CT scan.

Conclusion: The study, encompassing 11 relevant studies and 208 patients, predominantly men (81%), revealed that asymmetrical bilateral hip dislocations were exceptionally rare (0.01-0.02 percent). Contrary to expectations, this study challenges the presumed stronger association of traffic accidents with bilateral dislocations, presenting a statistically significant association between the type of dislocation and trauma mechanism. Associated fractures, such as acetabulum fractures in unilateral cases and posterior edge fractures in bilateral cases, varied. Avascular necrosis (AVN), a common complication, was not observed in the current case, where reduction occurred within the critical 6-hour timeframe. This report contributes valuable insights into the characteristics and associations of asymmetric bilateral hip dislocations, emphasizing the importance of prompt intervention to mitigate complications. Further research is needed to validate these findings and explore underlying patterns in this rare clinical scenario.