Huang K, Giddins G, Zhang JF, Lu JW, Wan JM, Zhang PL, Zhu SY. Asymmetrical traumatic bilateral hip dislocations with hemodynamic instability and an unstable pelvic ring: Case report and review of literature. World J Clin Cases 2018; 6(5): 94-98 [PMID: 29774222 DOI: 10.12998/wjcc.v6.i5.94]
Corresponding Author of This Article
Kai Huang, MD, Attending Doctor, Surgeon, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Gucui Road 234, Hangzhou 310012, Zhejiang Province, China. hzhuangk@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kai Huang, Jian-Fang Zhang, Jian-Wei Lu, Jun-Ming Wan, Peng-Li Zhang, Shao-Yu Zhu, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Grey Giddins, Department of Orthopedics, Royal United Hospital Bath, BA1 3NG, United Kingdom
Author contributions: Huang K accountable for the execution of the case report, the integrity and analysis of the data and the writing of the manuscript; Giddins G accountable for the process of analyzing the case and writing the manuscript; Zhang JF accountable for the conception and execution of the case report; Lu JW is the senior author who is the treating surgeon of the patient; Wan JM, Zhang PL and Zhu SY contributed substantially to the process of analyzing the case and writing the manuscript; all authors read and approved the final manuscript.
Supported by Zhejiang Scientific and Technological Plan of Traditional Chinese Medicine, No. 2018ZB033; Zhejiang Medical and Health Science and Technology Project, No. 2018234792.
Informed consent statement: Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Report of this case is approved by the ethics committee of Tongde Hospital of Zhejiang Province.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kai Huang, MD, Attending Doctor, Surgeon, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Gucui Road 234, Hangzhou 310012, Zhejiang Province, China. hzhuangk@163.com
Telephone: +86-571-89972114 Fax: +86-571-88853199
Received: February 13, 2018 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 Processing time: 92 Days and 5.9 Hours
Abstract
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.
