Simultaneous traumatic dislocation of the hip knee and ankle joints in an ipsilateral limb, does it happen? A case report

Lokesh Kumar S. N., Deepak Kumar, Sameer Aggarwal


Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.


Ankle joint in a single limb retrospective, Dislocation of hip knee, Simultaneous traumatic triple dislocation in an ipsilateral limb, Traumatic triple dislocation, Triple dislocation of lower limb

Full Text:



Schmidt GL, Sciulli R, Altman GT. Knee injury in patients experiencing a high-energy trauĀ¬matic ipsilateral hip dislocation. J Bone Joint Surg Am. 2005;87(6):1200-04.

Tabuenca J, Truan JR. Knee injuries in traumatic hip dislocation. Clin Orthop. 2000;(377):78-83.

Waterman BR, Banerjee R. Management of Simultaneous Ipsilateral Dislocation of Hip, Knee, and AnkleAm J Orthop. 2011;40(6):301-4.

Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58:453-8.

Allis OH. The Hip. Philadelphia: Dorman; 1895; 14-26.

Ficat RP. Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg Br. 1985;67:3-9.

Malimson PD. Triple fracture-dislocation of the lower limb. Injury. 1984;16(1):11-2.

Millea TP, Romanelli RR, Segal LS, Lynch CJ. Ipsilateral fracture-dislocation of the hip, knee, and ankle: Case report. J Trauma. 1991;31(3):416-9

Hatori M, Kotajima S, Smith RA, Kokubun S. Ankle dislocation without accompanying malĀ¬leolar fracture. A case report. Ups J Med Sci. 2006;111(2):263-8.

Rivera F, Bertone C, De Martino M, Pietrobono D, Ghisellini F. Pure dislocation of the ankle: three case reports and literature review. Clin Orthop. 2001;(382):179-84.

Soyer AD, Nestor BJ, Friedman SJ. Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis: a case report. Foot Ankle Int. 1994;15(11):622-4.

Waterman BR, Banerjee R. Management of Simultaneous Ipsilateral Dislocation of Hip, Knee, and Ankle. Am J Orthop. 2011;40(6):301-4

Gillespie WJ. The incidence and pattern of knee injury associated with dislocation of the hip. J Bone Joint Surg Br. 1975;57(3):376-8.

Sahin V, Karakas ES, Aksu S, Atlihan D, Turk CY, Halici M. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma 2003;54(3):520-9.

Jones RE, Smith EC, Bone GE. Vascular and orthopaedic complications of knee dislocation. Surg Gynecol Obstet. 1979;149(4):554-8.