Traumatic hip dislocation with fracture of the ipsilateral femoral shaft in childhood

Summary

Ipsilateral concomitant hip dislocation and femoral shaft fracture in childhood is extremely rare. A further case and a literature review, with 35 additional observations are presented. The dislocation was initially missed in more than 50% of cases, but when immediately diagnosed, closed reduction manoeuvres were effective in all observations but one, and results were rated normal. As delayed reduction predisposes to avascular necrosis, every child with a femoral shaft fracture should be given a routine X-rays of pelvis, including lateral hip views, as a safeguard against missing an associated hip dislocation. If present, its urgent closed reduction is imperious. In case of failure, closed or open purchasing of the proximal shaft fragment to allow a sort of skeletal-handling is to be used. Open reduction of the dislocation is to be regarded as the third-line procedure.