1
|
Jlidi M, Bouaicha W, Mallek K, Gharbi MH, Jaziri S, Daas S. A rare concomitant ipsilateral hip and knee dislocations: A case report and review of the literature. SAGE Open Med Case Rep 2024; 12:2050313X241233199. [PMID: 38410690 PMCID: PMC10896048 DOI: 10.1177/2050313x241233199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Ipsilateral hip and knee dislocation is a rare and complex injury that usually results from high-energy trauma. Only 14 cases were reported in the literature so far. We report the case of a 35-year-old man who presented with an ipsilateral right hip and knee dislocation after being involved in a road traffic accident. A contralateral floating knee was associated. The hip dislocation was associated to a posterior wall fracture of the acetabulum and a femoral head fracture. The knee dislocation was compound and associated with a patella fracture. The hip dislocation was reduced. The posterior wall and the femoral head fractures were treated conservatively. The knee dislocation was reduced and stabilized by external fixator. Early postoperative infection occurred and was treated surgically. At the last follow-up, the knee was ankylosed at 5° of flexion with a bony bridge between the femoral condyle and the tibial plateau. The patient described an occasional hip pain on exertion. He had full range of motion of the right hip. No avascular necrosis of the femoral head was seen. Outcomes of simultaneous hip and knee dislocation are very variable and remain unpredictable. The timing of reducing the hip joint and the knee.
Collapse
Affiliation(s)
- Mohamed Jlidi
- Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Walid Bouaicha
- Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Karim Mallek
- Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Mohamed Hedi Gharbi
- Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Salma Jaziri
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Anesthesia and Intensive Care, Mohamed Bourguiba Hospital, El Kef, Tunisia
| | - Selim Daas
- Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
2
|
LaRoque MC, Zeni F, Cole PA. Traumatic Bifocal whereas and Ipsilateral Posterior Knee Dislocation: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00028. [PMID: 36735805 DOI: 10.2106/jbjs.cc.22.00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CASE A 19-year-old man sustained combined, ipsilateral inferior hip and posterior knee fracture-dislocations secondary to a motor vehicle collision. He underwent immediate closed reduction of the knee and delayed open reduction internal fixation but required emergent open hip reduction for an irreducible femoral head incarcerated on a pubic root fracture. At the 1-year follow-up, he demonstrated excellent functional outcome with painless and full hip and knee range of motion. CONCLUSION Irreducible inferior femoral head dislocation in combination with a knee dislocation requires thoughtful staging and treatment but can result in satisfactory outcomes.
Collapse
Affiliation(s)
- Michael C LaRoque
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.,Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota
| | - Ferras Zeni
- Allina Health Orthopedics, Minneapolis, St. Paul, Minnesota
| | - Peter A Cole
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.,Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota.,HealthPartners Orthopaedics & Sports Medicine, Bloomington, Minnesota
| |
Collapse
|
3
|
Perumal R, Shankar V, Yalavarthi RK, Jayaramaraju D, Rajasekaran S. Gluteus medius avulsion in posterior hip fracture dislocation–A rare injury. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2019. [DOI: 10.1016/j.jotr.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 44-year-old male presented to us with right hip pain and limb shortening following road traffic accident. He was diagnosed to have blunt abdominal injury, right hip posterior fracture dislocation, right knee dislocation with vascular injury. Though vascular repair was attempted, he ended up with an above knee amputation. Hip joint was unstable even after closed reduction and intraoperatively, gluteus medius avulsion was noted. This is the second reported case of abductor tendon avulsion in posterior hip dislocations.
Collapse
Affiliation(s)
- Ramesh Perumal
- Department of Orthopaedic &Spine Surgery, Ganga Hospital, Mettupalayam Road, Coimbatore 641 011, India
| | - Vijay Shankar
- Department of Orthopaedic &Spine Surgery, Ganga Hospital, Mettupalayam Road, Coimbatore 641 011, India
| | - Rakesh K. Yalavarthi
- Department of Orthopaedic &Spine Surgery, Ganga Hospital, Mettupalayam Road, Coimbatore 641 011, India
| | | | | |
Collapse
|
4
|
Arenas Miquelez A, Familiari F, Arbeloa L, D'Arrigo Azzarelli A. Simultaneous Ipsilateral Dislocation of the Hip and the Knee: A Case Report. JBJS Case Connect 2017; 7:e85. [PMID: 29286969 DOI: 10.2106/jbjs.cc.17.00036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome. CONCLUSION Simultaneous ipsilateral hip and knee dislocations are rare and complex injuries that usually result from high-energy trauma. In order to avoid severe neurovascular complications, they need prompt management. Nonoperative treatment followed by an intensive rehabilitation program should be considered as an alternative treatment to surgery in older patients with a low-demand lifestyle.
Collapse
Affiliation(s)
- Antonio Arenas Miquelez
- Department of Trauma and Orthopaedic Surgery, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Filippo Familiari
- Department of Orthopaedic Surgery, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Lucas Arbeloa
- Department of Trauma and Orthopaedic Surgery, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Andrea D'Arrigo Azzarelli
- Department of Trauma and Orthopaedic Surgery, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| |
Collapse
|
5
|
Perumal R, Sundararajan SR, Vasudeva J, Rajasekaran S. Ipsilateral Hip and Knee Dislocation with Open Tibial Fracture: A Case Report of a Limb Threatening Injury. J Orthop Case Rep 2017; 6:47-50. [PMID: 28507966 PMCID: PMC5404162 DOI: 10.13107/jocr.2250-0685.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Hip or knee dislocations are usually treated as a surgical emergency, but ipsilateral hip and knee dislocation should be considered a dual emergency that must be addressed immediately and reduced at the earliest. We present here the sequence of events and the final functional outcome of one such rare injury manages by us. CASE REPORT A 22-year-old male was involved in a road traffic accident. He presented to the emergency department in 4 h injury time with painful deformities of the right hip and knee, along with Type I open wound right leg with abnormal mobility suggestive of fracture in the ipsilateral leg. CONCLUSION Simultaneous ipsilateral hip and knee fracture-dislocation with open tibial fracture is a rare injury that should be approached as limb-threatening injury and dual orthopedic emergency. We report this case for its rarity and to document that good results can be achieved with early appropriate treatment.
Collapse
Affiliation(s)
- Ramesh Perumal
- Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India
| | - S R Sundararajan
- Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India
| | - J Vasudeva
- Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India
| | - S Rajasekaran
- Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India
| |
Collapse
|
6
|
Ipsilateral hip and knee dislocation: Case report and review of literature. J Clin Orthop Trauma 2016; 7:115-21. [PMID: 27182149 PMCID: PMC4857168 DOI: 10.1016/j.jcot.2016.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 02/16/2016] [Indexed: 10/22/2022] Open
Abstract
Hip and knee dislocations are not uncommon but simultaneous ipsilateral dislocation of the hip and knee joint is rare; consequently, there is an inadequate amount of literature on the subject. We identified only 11 such cases reported in English literature. In the present report, we describe the case of a 23-year-old male patient who presented with ipsilateral hip and knee dislocation on the right side after being involved in a road traffic accident. The hip dislocation was associated with a posterior wall acetabular fracture. The hip as well as the knee joints was reduced in the emergency bay. The patient underwent an urgent fixation of the posterior wall acetabular fracture with delayed ligament reconstruction for the knee dislocation. At one-year follow-up, he had no pain in the hip or knee. There was grade 1 posterior sag but no symptoms of knee instability. Radiographs revealed no evidence of avascular necrosis or arthritis of the femoral head. The normal treatment protocol for individual injury is affected by the simultaneous occurrence of hip and knee dislocation.
Collapse
|
7
|
Traumatic bilateral knee dislocations, unilateral hip dislocation, and contralateral humeral amputation: a case report. HSS J 2009; 5:40-4. [PMID: 19052715 PMCID: PMC2642548 DOI: 10.1007/s11420-008-9100-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Accepted: 10/22/2008] [Indexed: 02/07/2023]
Abstract
Bilateral traumatic knee dislocations are a rarity. We report a case of bilateral traumatic knee dislocations with concomitant right hip dislocation and complete traumatic amputation of the left, nondominant upper extremity at the level of the proximal one-third of the humerus. Angiograms revealed no evidence of popliteal artery injury. Orthopedic treatment consisted of immediate reduction of the dislocations and urgent revision amputation of the upper extremity. Staged, bilateral knee ligamentous reconstructions were performed on hospital days 24 and 29, respectively. Despite this constellation of devastating injuries, the patient had a satisfactory outcome. In patients with high-energy hip or knee dislocations, the bilateral hips and knees should be carefully examined to check for associated fractures and/or dislocations.
Collapse
|