A 5 year result of neglected posterior hip dislocation with unusual presentation of false acetabulum treat with skeletal traction followed by cemented total hip replacement: A case report.

Introduction And Importance: Neglected posterior hip dislocations in adults are rare, particularly when untreated for years. In developing nations, patients often rely on traditional bone setters, leading to delayed diagnosis and increased complications. Adult hip dislocations carry a higher risk of avascular necrosis and require complex treatments. This case illustrates a five-year delayed posterior hip dislocation with a false acetabulum, managed with skeletal traction and total hip replacement. This case report is written in compliance with the SCARE guideline.

Case Presentation: A 64-year-old Minahasa woman presented with six years of hip pain, gait issues, and functional limitations post-fall. Initially treated by a bone setter, the patient had an 8 cm limb length discrepancy, restricted hip motion, and a Harris Hip Score of 39 %. Imaging showed a high-displaced hip with a false acetabulum and acetabular fracture. Treatment involved a two-staged procedure: skeletal traction and reconstruction followed by cemented total hip replacement, resulting in significant recovery and a Harris Hip Score of 90 % after four years.

Clinical Discussion: Chronic hip dislocations present challenges due to fibrous tissue and muscle contractures. Skeletal traction facilitated the reduction of the dislocation and provided stabilization prior to the replacement surgery. Total hip replacement was required due to the extent of joint damage. A Staged management skeletal traction and reconstruction before surgery improve outcomes in such cases, making total hip replacement an optimal solution for chronic dislocations.

Conclusion: Total hip replacement is effective for neglected hip dislocations, restoring function and mobility, as demonstrated by this case's successful long-term outcome.