Neglected simultaneous bilateral asymmetric traumatic hip dislocation in a young male managed by closed reduction manoeuvres in a resource-limited setting: A case report

BACKGROUND: Asymmetric bilateral hip dislocations are rare, representing approximately 0.01 %–0.02 % of all joint dislocations. The treatment of neglected hip dislocations is difficult or impossible by closed reduction manoeuvres. This is a report of an unusual clinical entity of neglected simultaneous bilateral asymmetric traumatic hip dislocations in a young male, managed by closed reduction manoeuvres. CASE PRESENTATION: This is the case of a 29-years-old male who presented with neglected simultaneous bilateral asymmetric traumatic hip dislocations 5 weeks post injury. His condition was managed by closed reduction manoeuvres due to financial constraints. Under spinal anaesthesia, the left hip was successfully reduced. Due to an associated posterior acetabular wall fracture, the presence of osteo-chondral fragments and labral lesions, adequate reduction of the right hip was not achieved. The functional Harris Hip Score (HHS) of the left hip improved on every subsequent follow-up visits at the clinic from 70 at day 45 to 86 at day 90. The HHS of the right hip was poor at day 45 but however increased to 90 after total hip replacement was done. CONCLUSIONS: This is an unusual case of neglected simultaneous bilateral asymmetric traumatic hip dislocations in a young male, managed by closed reduction manoeuvres. Closed reduction of such injury is difficult and seldom successful with uncertain long term functional outcome.