COMPLICATED TRAUMATIC DISLOCATION OF THE HIP

Report of Three Cases

1. Although traumatic dislocation of the hip is an infrequent lesion, its presence should be suspected when the hip is held fixed in a distorted attitude following a severe injury.

2. Three cases of traumatic dislocation of the hip are reported. One was first seen by the writer six weeks after the injury; the second, nine weeks after the injury, and the third case on the day after the injury. The third case was complicated by a fracture of the shaft of the femur as well as a fracture of the head of the femur. The injury to the shaft of the bone completely overshadowed the hip lesion which had not been recognized.

3. It is possible to reduce these old dislocations weeks after their occurrence. One of these of the posterior variety was reduced by the closed method six weeks after the injury. Another (obturator) was reduced by open operation ten weeks after its occurrence.

4. The ages of these patients were in the twentieth to fortieth year limit, which as Baetjer has observed, is roughly the common age incidence. At an earlier and later period, fracture of the neck of the femur is most likely to occur.

5. Two of these patients were male and the other female.

6. These cases should be recognized earlier as the result of reduction of the old cases compares most unfavorably with the recent ones, particularly because of the subsequent occurrence of an osteo-arthritis.

7. The blood count in one patient is included as it illustrates the fact that a patient with considerable hemorrhage into the tissues, may show a leucocytosis and an increase in polymorphonuclear leucocytes from this source alone without additional complications.

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