Posterior hip dislocation associated with concomitant ipsilateral femoral head and shaft fractures: an unusual combination of injuries

2021 ◽  
Vol 14 (8) ◽  
pp. e244453
Author(s):  
Deepak Chouhan ◽  
Prateek Behera ◽  
Mohammed Tahir Ansari ◽  
Vijay Kumar Digge
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Trauma Management ◽  
Femur Head ◽  
Basic Principles ◽  
Shaft Fractures ◽  
Unusual Combination ◽  
Posterior Hip Dislocation

The combination of posterior hip dislocation with an ipsilateral femoral head and shaft fractures is unusual. While cases of concomitant fractures of femoral head and shaft have been previously reported, the treatment of such injuries is challenging. Presence of an associated hip dislocation further complicates the matter. A timely diagnosis and treatment are crucial to have a good outcome.We are presenting the case of a 20-year-old man who sustained a traumatic posterior hip dislocation with ipsilateral femoral shaft and femur head fractures. After reducing the hip, we fixed the femoral shaft with a retrograde femur nail and the femoral head by the trochanteric flip approach in the same sitting. The patient returned to his pre-injury occupation after 4 months. He has been doing well until his last follow-up, 1 year after the surgery, thus emphasising the utility of following basic principles of trauma management in the management of unusual injuries.

scholarly journals Simultaneous Ipsilateral “Floating Hip” with Hip Dislocation and Femoral Neck and Shaft Fractures Associated with “Floating Knee” Injuries with Patella Fracture and Traumatic Sciatic Nerve Injury

2021 ◽  
pp. 255-260
Author(s):  
Sasa S. Milenkovic ◽  
Milan M. Mitkovic
Keyword(s):  
Femoral Head ◽  
Sciatic Nerve ◽  
Nerve Injury ◽  
Knee Injuries ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Sciatic Nerve Injury ◽  
Fracture Dislocation ◽  
Shaft Fractures ◽  
Posterior Wall Fracture

Simultaneous ipsilateral “floating-hip” and “floating-knee” injuries are very rare and severe, and they occur in high-velocity road traffic accidents. A 55-year-old man presented with posterior wall fracture – dislocation of the acetabulum, complete fracture – dislocation of the femoral head, ipsilateral femoral shaft fracture, open patellar fracture, Gustilo type II, tibial fracture, and traumatic sciatic nerve injury/peroneal division. Given the fact that hip dislocation is an orthopedic emergency, we first did closed external tibial fixation, femoral head reduction, osteosynthesis of the acetabular fracture, and partial patellectomy. After 2 days, the patient underwent a second surgery; fixation of the neck and femoral shaft fractures was done, with a self-dynamic internal fixator. After 14 months from the injuries, radiographs show complete healing of all fractures, the patient walks independently without crutches, and the peroneal nerve is partially recovered. Despite the seriousness of the presented injuries, we did not have any complications, and 14 months after the injury, the femoral head is still viable, with no signs of femoral head osteonecrosis.

scholarly journals Delayed diagnosis of traumatic posterior hip dislocation in a 6-year-old girl with 6 years follow up: a case report

2017 ◽  
Vol 4 (10) ◽  
pp. 3511
Author(s):  
Paa Kwesi Baidoo ◽  
Boniface Adegah
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Delayed Diagnosis ◽  
Hip Dislocation ◽  
Traumatic Hip Dislocation ◽  
Left Posterior ◽  
Posterior Hip Dislocation

Though uncommon, cases of traumatic hip dislocation have been reported in children worldwide. Averagely, it is recommended that the acceptable duration for reduction after such dislocations is about 6 hours. Even with that there is about 5% documented chance of developing avascular necrosis of the head of the femur. The incidence of avascular necrosis increases with delayed relocation of the femoral head. We report a case involving a 6-year-old girl with a 2-week delayed diagnosis of a left posterior hip dislocation that was reduced and followed up for 6 years.

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

scholarly journals Partial resection of the posterior wall for hip dislocation in severe acetabular protrusio

2020 ◽  
Vol 1 (7) ◽  
pp. 431-437
Author(s):  
Hugo A. Rodriguez ◽  
Felipe Viña ◽  
Meilyn A. Muskus
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Partial Resection ◽  
Hip Arthroplasties ◽  
Acetabular Protrusio

Aims In elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio. Methods This is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe acetabular protrusio operated on between January 2007 and February 2017. Results In all, 49 hip arthroplasties were performed. The average age of patients was 60 years, and idiopathic was the most frequent aetiology of protrusio. All patients were treated with femoral head autograft and no intra- or postoperative complications were reported. No patients required revision surgery. Conclusion Partial resection of the posterior wall demonstrated to be a safe surgical technique with 100% survival in a follow-up to ten years in total hip arthroplasty due to severe acetabular protrusio. Cite this article: Bone Joint Open 2020;1-7:431–437.

scholarly journals Traumatic Obturator Hip Dislocation with Marginal Femoral Head Fracture in a 15-Year-Old Adolescent: A High-Energy Trauma—A Case Report and a Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yoann Durand ◽  
Clémence Bruyère ◽  
Marco Saglini ◽  
Aurélien Michel-Traverso
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
High Energy ◽  
Hip Pain ◽  
X Rays ◽  
Hip Function ◽  
One Year ◽  
High Level ◽  
Joint Limitation

We report the case of a 15-year-old boy brought to the emergency department after a bike accident, complaining of an isolated left hip pain. The X-rays showed an obturator hip dislocation treated by closed reduction under general anaesthesia, followed by 6 weeks of discharge. The follow-up MRI performed 6 weeks after the trauma showed an avascular femoral head necrosis, for which we performed multiple retrograde femoral head drilling, completed by the injection of autologue stem cells from the iliaq crest. One year later, the patient has no hip pain, no joint limitation, and can practice BMX at a high level again. The purpose of this report is to make the physicians aware of this rare problem that may be damaging for hip function, especially in young people.

scholarly journals Management of Recurrent Posterior Hip Dislocation in a Down Syndrome Patient with Dysplastic Hip Using Ganz Periacetabular Osteotomy: Follow Up After 4 Years

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
Ismail H. Dilogo ◽  
Jessica Fiolin
Keyword(s):  
Down Syndrome ◽  
Periacetabular Osteotomy ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Syndrome Patient ◽  
Down Syndrome Patient ◽  
Dysplastic Hip ◽  
Posterior Hip Dislocation

Recurrent hip dislocation in a Down Syndrome patient with dysplastic hip is a very challenging case to treat even for an expert orthopaedic hip surgeon. Least compliant patient and family, lowly educated with low socioeconomic status and the dysplastic hip forces limited option as a treatment. This is the first case world wide reporting 4 year follow up of dysplastic hip with Down Syndrome treated successfully with PAO technique. Methods: An eighteen years old female with history of Down Syndrome had multiple posterior hip dislocation episodes since 3 years prior. Several attempts of close reduction and hip spica applications were performed upon dislocation despite no successful retaining of reduction. Acetabular index of right hip were 550 and epiphyseal plate hasclosed. PatientwasperformedopenreductionusingSouthern-Mooreposteriorapproachand osteotomy of ischium, continued with capsulorrhaphy followed with Smith-Peterson anterior approach and osteotomy of superior ramus pubis and iliac bone. Then, derotation maneuver was performed under image intensifier to obtain adequate coveragefollowedwithbonegraftandfixationusing2cannulatedscrewandhipspica castapplication. Results: Within four years after surgery, the hip has never been dislocated again, patient could sit without pain and walk with full weight bearing although Harris Hip Score could not be performed due to Down Syndrome. Leg length discrepancy was negligible,fracture has fully united and acetabularin dex was300. Conclusions: Ganz periacetabular osteotomy, although a technically demanding surgery, is a preferable treatment in recurrent hip dislocation for Down Syndrome patient with good to excellent clinical and radiological ou tcome

OPYT PRIMENENIYa KOMPOZITsIONNYKh BIOSOVMESTIMYKh IMPLANTATOV V KLINIKE DETSKOY I PODROSTKOVOY ORTOPEDII

2003 ◽  
Vol 10 (1) ◽  
pp. 78-83
Author(s):  
O A Malakhov ◽  
G A Krasnoyarov ◽  
S I Belykh ◽  
O V Kozhevnikov ◽  
A V Ivanov ◽  
...  
Keyword(s):  
Experimental Study ◽  
Medical Technology ◽  
Surgical Intervention ◽  
Hip Dislocation ◽  
Varus Deformity ◽  
Functional Results ◽  
Lower Limbs ◽  
Femur Head ◽  
Congenital Hip Dislocation

Specialists from Children Orthopedic Clinic (CITO) and Institute of Medical Technology elaborated therapeutically active implants on the base of N-vinilpirrolidone and methylmethacrylate with different additives. Those implants were successfully applied in clinical practice. Experimental study on rabbits showed the possibility of implants to stimulate osteogenesis. Various types and shapes of implants were elaborated using different combinations of additives. Minimum invasive surgical intervention and indications to implants' application were worked out. From 1987 to 2001 one hundred thirteen patients with various pathology (obstetrical paresis, clubfoot, juvenile femur head ephiphysiolysis, congenital hip dislocation, funnel-shaped deformity of thorax, dystrophic varus deformity of femur head, osteochondropathy of lower limbs) were treated surgically using new implants. At 3-5 years follow up good and excellent anatomic and functional results were noted in 89% of cases.

scholarly journals “Acute Primary Total Hip Arthroplasty for Combined Posterior Acetabulum Fracture with Ipsilateral Associated Posteriorly Dislocated Femoral Head with Femoral Neck Fracture. Using of Femoral Head as an Autograft Would be an Advantage”

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Babaji Thorat ◽  
Avtar Singh ◽  
Mohammad Arshad ◽  
Sharad Salokhe ◽  
Ravi Mavani
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
High Energy ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Neck Fracture ◽  
Posterior Hip Dislocation

Introduction: Traumatic posterior hip dislocation with comminuted fracture of the ipsilateral acetabulum and femoral neck is a rare fracture pattern. These injuries are associated with high energy trauma and pose challenges during management. Controversy exists between hip preservation and replacement surgeries in middle-age patients. Open reduction and internal fixation (ORIF) have a high risk of non-union, avascular necrosis, and post-traumatic osteoarthritis of hip requiring total hip arthroplasty hip replacement (THA) as a secondary procedure later. Case Report: A 56-year-old male presented with posterior hip dislocation and comminuted fracture of ipsilateral wall and column of the acetabulum, and femoral neck following a high energy trauma. He was managed by acetabular reconstruction using femoral head structural autograft combined with acute primary uncemented THA. At 2-year follow-up, the patient had good functional outcome with a satisfactory range of motion without any difficulty in weight-bearing and doing his daily activities. Conclusion: Although uncommon, acetabular reconstruction using femoral head structural autograft and acute primary uncemented THA is a viable alternative treatment option compared to ORIF in middle-age patients with fracture of ipsilateral neck and acetabulum. This facilitates post-operative rehabilitation and avoids further operations for possible developing AVN or secondary arthritis. Keywords: Hip dislocation, acetabulum fracture, femur neck fracture, acute total hip arthroplasty, acetabular reconstruction, femoral head structural autograft.

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