Total hip arthroplasty in young patient after neglected hip dislocation: a rare case report and literature review

Introduction: Total hip replacement (THR) is an effective procedure for various hip joint conditions, including osteoarthritis, rheumatoid arthritis, hip dysplasia, and avascular necrosis (AVN). Neglected hip dislocation, particularly posterior dislocation, can result in serious side effects including AVN and necessitate complex surgical procedures like THR. AVN in younger patients presents unique challenges, such us the possibility implant failure and the requirement for multiple surgeries. Case report: A 22 year old female, came with complaints of stiffness in her left hip joint, and pain when sitting when sitting for extended periods of time, which had been present for four months prior to admission. She reportedly fell seven months ago, but she never got any medical treatment. Additionally, there is also no family history of congenital defect, or musculoskeletal problems. Physical examination shows a normal right lower limb, whereas her left lower limb is deformed, exhibiting flexion, shortening, and adduction, along with a limited range of motion. Discussion: A young adult female presenting with chronic hip pain due to neglection dislocation, upon examination, it was found that her femoral head is not vital anymore. She was then treated with total hip arthroplasty and went through physical therapy to recover functionally. Her Harris Hip Score recovered to near normal. Conclusion: Total Hip Arthroplasty in young adults with Neglected hip dislocation provides excellent results in the management of avascular necrosis and remains the treatment of choice. The cause of her necrosis is rare, however, in especially at developing countries, due to the belief of natural bone setter, neglect of dislocation and fracture is common, orthopedic surgeons in developing countries need to be aware of the possibility of complications associated with neglection.