JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Article

An Atypical Presentation of Hip Dislocation In A Pregnant Patient: A Case Report and Review of the Literature
  • VIEWS 66
  • PDF 20

Journal of Clinical and Biomedical Sciences

DOI: 10.58739/jcbs/v14i1.23.1

Year: 2024, Volume: 14, Issue: 1, Pages: 23-26

Case Report

An Atypical Presentation of Hip Dislocation In A Pregnant Patient: A Case Report and Review of the Literature

Ayush Agrawal1, Madhavan P2,*, Hariprasad S3

1 Junior Resident, Department of Orthopaedics, SDUMC, Kolar, Karnataka
2 Senior Resident, Department of Orthopaedics, SDUMC, Kolar, Karnataka
3 Professor, Department of Orthopaedics, SDUMC, Kolar, Karnataka

*Corresponding author email: [email protected]

Received Date:29 September 2023, Accepted Date:19 March 2024, Published Date:30 March 2024

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Managing an injured patient who is pregnant can be difficult in the management and investigation of the case especially when the patient presents atypically. We encountered a 25-year-old female patient who sustained a posterior dislocation of the right hip and was pregnant at 12 weeks gestation following a road traffic accident. The patient presented to OPD with an atypical attitude of limb i.e., both hip and knee in flexion without any internal rotation and adduction of the limb following which MRI was done which showed right hip posterior dislocation. Through an interdepartmental, skilful team approach the patient, after taking the obstetrician’s opinion and the patient under short GA, Closed reduction by Rochester method (longitudinal traction and rotation control) was done for the right hip joint without any complication. As pregnant females possess more risk and complication and more challenges are expected in management, Orthopaedic surgeons are well equipped to treat such patients to reduce patient morbidity and mortality resulting in better outcomes.

 

Keywords

Posterior dislocation of hip, Pregnant female, Atypical presentation, Closed reduction

References

  1. Young JR, Vignaly L, Carroll J, Ross P, Mori BV, Czajka CM. Combined Acetabulum Fracture and Hip Dislocation in an 18-Year-Old Female at 35-Week Gestation: A Case Report and Review of the Literature. Case Reports in Orthopedics. 2020;2020:1–6. Available from: https://doi.org/10.1155%2F2020%2F8888015
  2. Pape HC, Pohlemann T, Gänsslen A, Simon R, Koch C, Tscherne H. Pelvic Fractures in Pregnant Multiple Trauma Patients. Journal of Orthopaedic Trauma. 2000;14(4):238–244. Available from: https://dx.doi.org/10.1097/00005131-200005000-00003
  3. Tejwani N, Klifto K, Looze C, Klifto CS. Treatment of Pregnant Patients With Orthopaedic Trauma. Journal of the American Academy of Orthopaedic Surgeons. 2017;25(5):e90–e101. Available from: https://dx.doi.org/10.5435/jaaos-d-16-00289
  4. Hill CC, Pickinpaugh J. Trauma and Surgical Emergencies in the Obstetric Patient. Surgical Clinics of North America. 2008;88(2):421–440. Available from: https://dx.doi.org/10.1016/j.suc.2007.12.006
  5. Al-Thani H, El-Menyar A, Sathian B, Mekkodathil A, Thomas S, Mollazehi M, et al. Blunt traumatic injury during pregnancy: a descriptive analysis from a level 1 trauma center. European Journal of Trauma and Emergency Surgery. 2019;45(3):393–401. Available from: https://dx.doi.org/10.1007/s00068-018-0948-1
  6. Connolly A, Katz V, Bash K, McMahon M, Hansen W. Trauma and Pregnancy. American Journal of Perinatology. 1997;14(06):331–336. Available from: https://dx.doi.org/10.1055/s-2007-994155
  7. Hull SB, Bennett S. The pregnant trauma patient: assessment and anesthetic management. International Anesthesiology Clinics. 2007;45(3):1–18. Available from: https://doi.org/10.1097/aia.0b013e3180f30fd6
  8. Muench MV, Canterino JC. Trauma in Pregnancy. Obstetrics and Gynecology Clinics of North America. 2007;34(3):555–583. Available from: https://dx.doi.org/10.1016/j.ogc.2007.06.001
  9. Pearlman MD. Motor vehicle crashes, pregnancy loss and preterm labor. International Journal of Gynecology & Obstetrics. 1997;57:127–132. Available from: https://dx.doi.org/10.1016/s0020-7292(96)02829-9
  10. ACOG educational bulletin. Obstetric aspects of trauma management. International Journal of Gynecology & Obstetrics. 1999;64(1):87–94. Available from: https://pubmed.ncbi.nlm.nih.gov/10190681/
  11. Hill KL, Gross ME, Sutton KM, Mulcahey MK. Evaluation and Resuscitation of the Pregnant Orthopaedic Trauma Patient. JBJS Reviews. 2019;7(12):e3. Available from: https://dx.doi.org/10.2106/jbjs.rvw.19.00013
  12. Horstmann P, Larsen CF, Grønborg H. Adherence to protocol in pregnant trauma patients? A 12-year retrospective study. European Journal of Trauma and Emergency Surgery. 2014;40:561–566. Available from: https://dx.doi.org/10.1007/s00068-014-0378-7
  13. Flik K, Kloen P, Toro JB, Urmey W, Nijhuis JG, Helfet DL. Orthopaedic Trauma in the Pregnant Patient. Journal of the American Academy of Orthopaedic Surgeons. 2006;14(3):175–182. Available from: https://dx.doi.org/10.5435/00124635-200603000-00008
  14. Curet MJ, Schermer CR, Demarest GB, Bieneik EJ, Curet LB. Predictors of Outcome in Trauma during Pregnancy: Identification of Patients Who Can Be Monitored for Less than 6 Hours. The Journal of Trauma: Injury, Infection, and Critical Care. 2000;49(1):18–25. Available from: https://dx.doi.org/10.1097/00005373-200007000-00003
  15. Herfel ES, Hill JH, Lieber M. Radiographic evaluation of the pregnant trauma patient: What are We willing to miss? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2018;228:325–328. Available from: https://dx.doi.org/10.1016/j.ejogrb.2018.06.039
  16. Toppenberg KS, Hill DA, Miller DP. Safety of radiographic imaging during pregnancy. American family physician. 1820;59(7):1813–1821. Available from: https://pubmed.ncbi.nlm.nih.gov/10208701/
  17. Raptis CA, Mellnick VM, Raptis DA, Kitchin D, Fowler KJ, Lubner M, et al. Imaging of Trauma in the Pregnant Patient. RadioGraphics. 2014;34(3):748–763. Available from: https://dx.doi.org/10.1148/rg.343135090
  18. Sakamoto J, Michels C, Eisfelder B, Joshi N. Trauma in Pregnancy. Emergency Medicine Clinics of North America. 2019;37(2):317–338. Available from: https://dx.doi.org/10.1016/j.emc.2019.01.009
  19. Porter SE, Russell GV, Qin Z, Graves ML. Operative Fixation of Acetabular Fractures in the Pregnant Patient. Journal of Orthopaedic Trauma. 2008;22(8):508–516. Available from: https://dx.doi.org/10.1097/bot.0b013e3181847a42
  20. Yosipovitch Z, Goldberg I, Ventura E, Neri A. Open Reduction of Acetabular Fracture in Pregnancy. Clinical Orthopaedics and Related Research. 1992;282:229–232. Available from: https://dx.doi.org/10.1097/00003086-199209000-00030
  21. Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery during pregnancy. British Journal of Anaesthesia. 2011;107:i72–i78. Available from: https://dx.doi.org/10.1093/bja/aer343
  22. Duncan P, Pope WB, Cohen M, Greer N. Fetal Risk of Anesthesia and Surgery during Pregnancy. Anesthesiology. 1986;64(6):790–794. Available from: https://dx.doi.org/10.1097/00000542-198606000-00019
  23. Cheek TG, Baird E. Anesthesia for Nonobstetric Surgery: Maternal and Fetal Considerations. Clinical Obstetrics & Gynecology. 2009;52(4):535–545. Available from: https://dx.doi.org/10.1097/grf.0b013e3181c11f60

Copyright

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Published By Sri Devaraj Urs Academy of Higher Education, Kolar, Karnataka

  • 27 April 2024

Year: 2024, Volume: 14, Issue: 1

Article Metrics


More articles

DON'T MISS OUT!

Subscribe now for latest articles and news.