J Korean Hip Soc.  2008 Sep;20(3):215-219. 10.5371/jkhs.2008.20.3.215.

Surgical Treatment of Posterosuperior Hip Dislocation in A Patient with Hereditary Sensory Autonomic Neuropathy Type IV: A Case Report

• Cho JH
• Kim SH
• Kim JY
• Won WY

• KMID: 2162630
• DOI: http://doi.org/10.5371/jkhs.2008.20.3.215

Abstract

A 4-year old female patient with a diagnosis of hereditary sensory autonomic neuropathy type IV (congenital insensitivity to pain with anhidrosis) since the age of 1 year, sustained a posterior hip dislocation. During her initial stay at the hospital, an attempt at manual reduction failed. Open reduction, capsulorrhaphy, and Salter operation were done at 36 days after the index dislocation. After the operation there was a 23-degree acetabular index, and there were several abnormal round whitish gray fibrous nodules. There was also severe wound discharge, skin abrasion, and erythema on the patient's back and buttocks due to loss of protective sensation. After conservatively treating the wound and skin problems with prone positioning, we achieved a final acetabular index of 26 degrees. The patient did not have protective sensation in her hip joint. We were able to check for increasing instability after the index operation.

Keyword

Hip dislocation; Hereditary sensory autonomic neuropathy type IV; Anhidrosis; Salter innominate osteotomy

MeSH Terms

Buttocks
Dislocations
Erythema
Female
Hip
Hip Dislocation
Hip Joint
Humans
Hypohidrosis
Sensation
Skin