Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Orthopedics
Volume 2014 (2014), Article ID 804098, 4 pages
http://dx.doi.org/10.1155/2014/804098
Case Report

An Unusual Complication Seen in a Six-Year-Old Girl Treated with Open Reduction and Pemberton Osteotomy for Neglected Developmental Dysplasia of the Hip: A Femoral Neck Fracture Sustained during Passive Motion under General Anesthesia

1Department of Orthopedics and Traumatology, Medicine Faculty of Mustafa Kemal University, Antakya, Hatay, Turkey
2Department of Orthopedics and Traumatology, Ergani State Hospital, Diyarbakır, Turkey

Received 13 February 2014; Revised 13 May 2014; Accepted 17 May 2014; Published 26 May 2014

Academic Editor: Mohamed Zamzam

Copyright © 2014 Vedat Uruc and Samet Karabulut. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Despite the screening programs for newborn children with hip ultrasonography, neglected developmental dysplasia of the hip (DDH) is still continuing to be a problem in the east and southeast parts of our country. The main complications are redislocation, avascular necrosis, and joint stiffness. We present an unusual complication, femoral neck fracture during passive motion under general anesthesia, of a six-year-old girl with neglected DDH treated by open reduction and Pemberton osteotomy without femoral shortening. The fracture was treated by open reduction and internal fixation combined with proximal femoral shortening. After 5 years the patient had excellent clinical results, no avascular necrosis was seen, and the radiologic appearance was type IA according to modified Severin classification. In conclusion older children with neglected DDH are more likely to have joint stiffness after open reduction. If there is even a little doubt about joint stiffness after open reduction, one should not refrain from femoral shortening. Also passive motion under general anesthesia should be applied very carefully with fluoroscopic control.