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Falgons CG, Warner SJ. Simultaneous ipsilateral hip and knee dislocation: Management and outcome - A case report. Trauma Case Rep 2024; 53:101079. [PMID: 39139729 PMCID: PMC11321382 DOI: 10.1016/j.tcr.2024.101079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/15/2024] Open
Abstract
Case This clinical case report presents a 40-year-old male who sustained an ipsilateral hip and knee dislocation with ipsilateral femoral head fracture and incomplete femoral neck fracture following a motorcycle collision. Conclusion This report describes acute and later definitive orthopedic care and management, with focus on urgent interventions and timing of immediate treatments. Given the presented patient's favorable clinical outcomes, return to baseline activities, and absence of significant sequelae following injury, the considerations from the acute management and surgical planning of this patient's injuries can be used as a reference for treating the rare injury of ipsilateral knee and hip dislocations.
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Affiliation(s)
- Christian G. Falgons
- Corresponding author at: Department of Orthopaedic Surgery, McGovern Medical School at UTHealth Houston, 6400 Fannin Street, Suite 1700, Houston, TX 77030, United States of America.
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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.
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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
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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.
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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
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Jain M, Sathia S, Mahapatra R, Swaroop S, Doki S. Triple blow injury to a limb: Ipsilateral hip and knee dislocation with vascular occlusion. J Emerg Trauma Shock 2020; 13:309-311. [PMID: 33897150 PMCID: PMC8047964 DOI: 10.4103/jets.jets_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 08/12/2020] [Accepted: 09/12/2020] [Indexed: 11/04/2022] Open
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Fageir M, Veettil MKP. Posterior dislocation of a native hip joint associated with ipsilateral per-trochanteric fracture: A rare case report. Trauma Case Rep 2018; 13:1-13. [PMID: 29644290 PMCID: PMC5887114 DOI: 10.1016/j.tcr.2017.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 12/26/2022] Open
Abstract
We describe a case of traumatic posterior dislocation of a native hip joint associated with ipsilateral comminuted inter-trochanteric femoral fracture. In our case, closed reduction was attempted but proved unsuccessful. Taking into account the planned subsequent intra-medullary femoral nail, open reduction through a lateral incision was undertaken. Post-operatively, the planned mobility was for a non-weight bearing period of 6 weeks followed by a partial-weight bearing period of 6 weeks before progressing to full-weight bearing. Post-operatively, the patient completed a comprehensive course of physiotherapy. At five months, he was able to walk for five miles over the course of a weekend. At six months, the patient was looking at phased return to work as a fire fighter. Radiographs taken at the time demonstrated evidence of healing to his inter-trochanteric fracture. At ten months, the patient was back to normal duties at work as a fire fighter.
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Affiliation(s)
- Mazin Fageir
- Department of Trauma and Orthopaedics Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Rd, Southampton SO16 6YD, United Kingdom
| | - Manoj Kumar Puthiyavaniya Veettil
- Department of Trauma and Orthopaedics Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Rd, Southampton SO16 6YD, United Kingdom
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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.
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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
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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.
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Chotai PN, Ebraheim NA, Hart R, Wassef A. Concomitant Posterior Hip Dislocation, Ipsilateral Intertrochanteric- and Proximal Tibial- Fractures with Popliteal Artery Injury: A Challenging Trauma Mélange. Clin Pract 2015; 5:776. [PMID: 26918095 PMCID: PMC4745589 DOI: 10.4081/cp.2015.776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/24/2015] [Accepted: 11/18/2015] [Indexed: 12/26/2022] Open
Abstract
Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome.
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Affiliation(s)
- Pranit N Chotai
- Department of Orthopedic Surgery, University of Toledo Medical Center , Toledo, OH, USA
| | - Nabil A Ebraheim
- Department of Orthopedic Surgery, University of Toledo Medical Center , Toledo, OH, USA
| | - Ryan Hart
- Department of Orthopedic Surgery, University of Toledo Medical Center , Toledo, OH, USA
| | - Andrew Wassef
- Department of Orthopedic Surgery, University of Toledo Medical Center , Toledo, OH, USA
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Góes Junior AMDO, Fernandes AR, Almeida CCD, Neves Junior MAD, Melo RC, Manzioni R, Rabboni E. Trauma fechado de artéria poplítea com evolução atípica: relato de caso. J Vasc Bras 2010. [DOI: 10.1590/s1677-54492010000200013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
A luxação traumática do joelho está associada a extensos danos músculo-ligamentares. Quando lesões neurovasculares estão presentes, o prognóstico é agravado e a viabilidade da extremidade torna-se francamente ameaçada. Em caso de lesão arterial poplítea, a abordagem deve ser feita o quanto antes sob pena de perda do membro, que, em algumas séries, alcança 80%. Os autores relatam o caso de um paciente jovem vítima de luxação traumática do joelho esquerdo associada a fraturas do acetábulo e da diáfise do fêmur ipsilaterais, com diagnóstico tardio (no quinto dia pós-trauma) de lesão da artéria poplítea. O paciente foi submetido a revascularização do membro e teve evolução satisfatória apesar da gravidade da lesão vascular, contrariando a evolução encontrada na literatura do trauma de artéria poplítea tratado tardiamente.
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