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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Emerg+Trauma+Shock
2018 ; 11
(1
): 53-56
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Bilateral Hip Dislocation: An Indicator for Emergent Full-Body Computed
Tomography Scan in Polytraumatized Patients? A Case Report and Review of the
Literature
#MMPMID29628670
Rufer B
; Keel MJB
; Schnüriger B
; Deml MC
J Emerg Trauma Shock
2018[Jan]; 11
(1
): 53-56
PMID29628670
show ga
We present a rare case of traumatic bilateral asymmetric hip dislocation with
pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist
was transferred to our emergency department with the suspicion of a bilateral hip
dislocation after he was trapped between an elevator and the roof. Immediate
closed reduction of the hips was not performed because of the expected risk of
increasing hemodynamic instability with muscular relaxation. An emergent
full-body computed tomography (CT) scan was made to assess injuries with need for
further operative treatment. Thus, closed reduction of both hips was finally
performed in the OR directly before the laparotomy for the diaphragmatic repair
and the osteosynthesis of the anterior pelvic ring. A 12-month follow-up showed
good general health condition with asymptomatic situation of the hip joints and
the abdomen. The diagnostic work-up of patients with severe trauma is still
debated, a randomized controlled trial showed no reduction of the in-hospital
mortality with immediate full-body CT scan compared to a conventional
radiological work-up. Traumatic hip dislocations (THDs) are always due to
high-energy trauma and additional injuries are frequent. To attempt a closed
reduction of THD, under general anesthesia can be life-threatening with
unrecognized associated injuries. Therefore, THD can serve as selection criteria
for immediate full-body CT scan to facilitate diagnosis and treatment of
associated injuries sustained by the patient.