Bilateral Hip Dislocation in Unrestrained Driver

History of present illness: A 24-year-old male was brought in by paramedics status post motor vehicle collision (MVC) into an electric pole and tree at high speed. The patient was an unrestrained driver who required extrication. The patient complained of left hip pain, left foot pain, and difficulty...

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Main Authors: Samer Assaf (Author), Ghadi Ghanem (Author)
Format: Book
Published: eScholarship Publishing, University of California, 2017-09-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Samer Assaf  |e author 
700 1 0 |a Ghadi Ghanem  |e author 
245 0 0 |a Bilateral Hip Dislocation in Unrestrained Driver 
260 |b eScholarship Publishing, University of California,   |c 2017-09-01T00:00:00Z. 
500 |a doi:10.21980/J8HD0C 
500 |a 2474-1949 
500 |a 2474-1949 
520 |a History of present illness: A 24-year-old male was brought in by paramedics status post motor vehicle collision (MVC) into an electric pole and tree at high speed. The patient was an unrestrained driver who required extrication. The patient complained of left hip pain, left foot pain, and difficulty extending his bilateral lower extremities. He denied numbness or tingling to his lower extremities. The patient had normal vitals; his bilateral lower extremities were held in flexion at the hips, but otherwise had no obvious injuries. The patient's pelvis was stable with palpable distal pulses and intact motor and sensory function of his distal lower extremities. Significant findings: The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula. Discussion: Bilateral hip dislocations are extremely rare, occurring in only 1% of all hip dislocations,2 and require immense force, typically occurring in MVCs (74%).3-7 Associated injuries include fracture of the acetabulum or femoral head, sciatic nerve damage, and obstruction of the blood supply to the femoral head.8 X-ray imaging and CT scans are used to assess the injury and to detect intra-articular fragments.3 Definitive treatment is achieved by closed reduction if possible; otherwise open reduction is utilized.9 Post-reduction therapy includes a non-weight-bearing period of time. Complications include avascular necrosis of the femoral head, osteonecrosis, and posttraumatic arthritis, the occurrence of which can be decreased by early reduction.4,10-12 This patient underwent bilateral closed hip reductions in the ER in conjunction with orthopedic surgery and underwent operative management of his pelvic fractures at a later date. 
546 |a EN 
690 |a Posterior hip dislocation 
690 |a dislocation reduction 
690 |a pelvis 
690 |a radiograph 
690 |a trauma 
690 |a Education 
690 |a L 
690 |a Special aspects of education 
690 |a LC8-6691 
655 7 |a article  |2 local 
786 0 |n Journal of Education and Teaching in Emergency Medicine, Vol 2, Iss 4, Pp V3-V5 (2017) 
787 0 |n http://jetem.org/bilateral_hip_dislocation/ 
787 0 |n https://doaj.org/toc/2474-1949 
787 0 |n https://doaj.org/toc/2474-1949 
856 4 1 |u https://doaj.org/article/ef5a0ee1d37b478ca2f26b00c8f7c23f  |z Connect to this object online.