Open anterior dislocation of the hip in an adult: a case report and review of literature☆☆☆

Open anterior hip dislocation is a rare condition and results from high-energy trauma. Ten cases of open anterior dislocation have been described in the literature so far. Its rarity is due to the inherent stability of the joint, its deep position in the pelvis, with strong ligaments and bulky muscles around the articulation. Several factors influence the prognosis, such as the degree of compounding, the associated soft tissue injuries, the age of the patient and, mainly, the delay in reduction. The main complications are: arthrosis of the hip, with incidence of 50% of cases, when associated with fractures of the femoral head; and osteonecrosis of the femoral head, with incidence between 1.7 and 40% (in closed anterior dislocation). Because of the rarity and the potential disability of this lesion, we report a case in a 46-year-old man, involved in an automobile accident. The hip was reduced (anterior superior dislocation) in the first three hours of the trauma. The patient was kept non-weight bearing until sixth week, with complete weight bearing after 10th week. After one year follow-up, the functional result was poor (Harris Hip Score: 52), probably because of the associated labral tear, but without signs of osteonecrosis of the femoral head in magnetic resonance imaging.