Trochanteric Digastric Approach for Chronic Hip Dislocation in a 31-Year-Old Man

Abstract

Chronic traumatic hip dislocations are rare, and there is little literature to guide management. Challenges include achieving adequate exposure, preserving vascular supply, and maintaining joint stability. This case shows the successful treatment of a chronic posterior hip dislocation in a 31-year-old man who presented six weeks after a road traffic accident with a 3.5 cm leg length discrepancy. The surgery was performed at eight weeks post-injury,
due to restrictions posed by COVID-19. We used the trochanteric digastric hip osteotomy to optimize joint exposure, aid in reduction, and preserve the vascularity of the femoral head. Intraoperatively, significant intra-articular fibrosis was identified and excised, and the hip was successfully reduced. The patient attained a Harris Hip Score of 90 in 12 weeks, with no evidence of osteonecrosis after two years of follow-up. This case demonstrates that the trochanteric digastric hip osteotomy is an effective approach for managing chronic hip dislocations, preserving femoral head vascularity, and restoring function with minimal complications.