A narrative review of traumatic hip dislocations in children and adolescents, examining age-specific pathophysiology, diagnostic pitfalls (including missed incongruous reductions and spontaneous incomplete reductions), and management complications. The paper synthesizes available case series to define best practices and highlight where errors in diagnosis and technique lead to osteonecrosis and other adverse outcomes.
When you see a pediatric hip dislocation, your first priority is concentric reduction within 6 hours — but in an adolescent (ages 12–16), first consider whether an unrecognized physeal injury is present, as forceful manipulation can convert a simple dislocation into a near-certain osteonecrosis.
Any post-reduction joint space widening on plain film is not benign: get a CT or MRI to rule out interposed tissue or osteochondral fragment before assuming the reduction is adequate.
A narrative review of traumatic hip dislocations in children and adolescents, examining age-specific pathophysiology, diagnostic pitfalls (including missed incongruous reductions and spontaneous incomplete reductions), and management complications. The paper synthesizes available case series to define best practices and highlight where errors in diagnosis and technique lead to osteonecrosis and other adverse outcomes.
When you see a pediatric hip dislocation, your first priority is concentric reduction within 6 hours — but in an adolescent (ages 12–16), first consider whether an unrecognized physeal injury is present, as forceful manipulation can convert a simple dislocation into a near-certain osteonecrosis.
Any post-reduction joint space widening on plain film is not benign: get a CT or MRI to rule out interposed tissue or osteochondral fragment before assuming the reduction is adequate.