Management of neglected traumatic posterior dislocations of the hip in developing countries

Abstract

Within a period of six months, three men were admitted following falls which had  occurred more than one week previously. They had all sustained minor trauma but  directly after the injury they were unable to bear weight on the affected limb. All three had Grade 1 posterior dislocations of the hip. Although the dislocation had  occurred more than one week previously, closed reduction under spinal anaesthesia was successful in each case. After reduction, the patients were put on traction for two weeks and then continued with partial weight-bearing for four weeks. Immediately after reduction physiotherapy was started. Following treatment, all  three patients walked without complaint. We concluded that a neglected posterior dislocation of the hip can be treated in a rural district hospital, with a trial of closed reduction under spinal anaesthesia. Successful reduction is essential to prevent further severe disability, after which further management can be discussed.

Key words: hip, dislocation, neglected, developing countries