scholarly journals Unusual Combination of Hip Dislocation with Ipsilateral Femoral Neck and Acetabulum Fracture: A Rare Case Report

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Ravi Gupta ◽  
Akash Singhal ◽  
Atul Rai Sharma ◽  
Anurag Patil ◽  
Gladson David Masih
Keyword(s):  
Case Report ◽  
Hip Joint ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
High Energy ◽  
Harris Hip Score ◽  
Aseptic Necrosis ◽  
Hip Joint Replacement ◽  
Acetabulum Fracture ◽  
Femur Neck

Introduction: Traumatic dislocation of hip associated with ipsilateral femur neck and acetabulum fracture is a rare and devastating injury as a result of high-energy trauma, with potential complications of femur head aseptic necrosis and hip joint degenerative arthritis. Patients, postoperatively, may encounter decreased functional outcomes and serious challenge, during activities of daily living. Management guidelines lack clarity, with possible options including fracture fragments fixation or hip joint replacement. Case Report: A 45-year-old patient was diagnosed with posterior dislocation of hip with ipsilateral femur neck and acetabulum fracture. Plan for emergent hip reduction and primary surgical fixation of fracture fragments was made. Intraoperatively, posterior wall acetabulum fracture was found to be excessively comminuted and non-amenable for fixation and femoral head was found to be avascularized. Subsequently, plan was changed to total hip replacement with acetabular defect reconstruction. At 1-year follow-up, no aseptic loosening was observed on radiographic views of pelvis, with total Harris Hip Score of 91. Conclusion: Early operative management for such complex injuries is a necessity. Definitive management in the form of primary fracture fixation/arthroplasty should be decided intraoperatively. Keywords: Femur neck, hip dislocation, acetabulum fracture, ipsilateral, case report.

scholarly journals Corrective Intertrochanteric Osteotomy of the Femur for Aseptic Necrosis of the Femoral Head after Bloodless Reduction of Congenital Dislocation in School-Age Children

2021 ◽  
Vol 07 (10) ◽  
Author(s):  
Khojaakhmed Shaykhislamovich Alpysbaev ◽  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dislocation ◽  
School Age Children ◽  
Congenital Dislocation ◽  
School Age ◽  
Greater Trochanter ◽  
Congenital Hip Dislocation ◽  
Aseptic Necrosis ◽  
Results Of Treatment

The immediate results of treatment of 72 children aged 7 to 12 years with aseptic necrosis of the femoral head after bloodless reduction of congenital hip dislocation were analyzed. When treating patients, the following types of surgical treatment were used:extra-articular or open centering of the femoral head with intertrochanteric-torsion-varizing or devarizing and rotational osteotomy of the femur with bringing down the greater trochanter in the caudal direction. In all patients, pain and lameness disappeared, internal rotation of the lower extremities when walking, and the range of motion in the hip joint improved. Improved radiometric parameters characterizing the ratio of the acetabulum and the head of the femur and the angular values of the hip joint and proximal femur.

scholarly journals Pediatric Hip Dislocation with Posterior Wall Acetabular Fracture: A Case Report

2014 ◽  
Vol 10 (3) ◽  
pp. 280-285
Author(s):  
Michael M. Khair ◽  
Christopher S. Smith ◽  
David L. Helfet
Keyword(s):  
Case Report ◽  
Acetabular Fracture ◽  
Hip Dislocation ◽  
Posterior Wall

scholarly journals Traumatic obturator–anterior type dislocation of the hip with an ipsilateral ischial tuberosity and greater trochanter fractures: Case report

2020 ◽  
pp. 221049172097898
Author(s):  
Juan Manuel Concha ◽  
Humberto Gonzalez ◽  
Andrea C Montero ◽  
Nelsy B Mueses ◽  
Heydy Y Muñoz ◽  
...  
Keyword(s):  
Hip Dislocation ◽  
Femoral Fractures ◽  
High Energy ◽  
Ischial Tuberosity ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Functional Evaluation ◽  
Greater Trochanter ◽  
Anterior Hip Dislocation ◽  
Trochanter Fracture

Anterior hip dislocation is a rare orthopedic emergency, usually following high-energy trauma. This injury is occasionally associated with acetabular fractures, femoral head fractures, or diaphyseal femoral fractures. However, the combination between the anterior hip dislocation and the ipsilateral ischial tuberosity and greater trochanter fractures is extremely rare, and very sparsely reported in the literature. This paper reports a case of an obturator type of anterior hip dislocation associated with a concomitant ipsilateral ischial tuberosity and greater trochanter fracture. The hip dislocation was reduced by closed means under general anesthesia, and the greater trochanter fracture was reduced and internally fixed with tension band in a second stage. Radiological and functional evaluation at 12 months after surgery, using the Harris Hip Score (HHS), was good.

scholarly journals Reconstruction of a hip socket using trabecular metal components

2019 ◽  
Vol 26 (1) ◽  
pp. 5-10
Author(s):  
N. V Zagorodny ◽  
O. A Alexanyan ◽  
G. A Cragan ◽  
S. V Kagramanov ◽  
B. U Iwunze
Keyword(s):  
Femoral Head ◽  
Bone Tissue ◽  
Hip Joint ◽  
Conflict Of Interest ◽  
Hip Prosthesis ◽  
Bone Defects ◽  
Structural Features ◽  
Harris Hip Score ◽  
Trabecular Metal ◽  
Aseptic Necrosis

Introduction. Fixation of the acetabular component in patients with bone defects of the acetabulum is a difficult task due to the insufficient quantity and poor quality of the remaining bone tissue. During the last few years in our country in arthroplasty of the acetabulum with severe bone defects were actively used implants made of trabecular metal. Purpose of study: was to evaluate short-term clinical and radiological results of the usage of trabecular metal components in patients with bone defects in revision and primary hip replacement. Patients and methods. 59 surgeries were performed using components of trabecular metal, 53 of them were performed on the instability of the hip prosthesis, 2 - post-traumatic hip dysplasia, 2 - aseptic necrosis of the femoral head, 2 - high dislocation of the femoral head. Among the operated there were 37 women and 22 men, the average age was 58.2±19.9 years. According to the Paprosky classification, defects in 12 cases corresponded to type IIA, in 14 - type IIB, in 6 - type II, in 19 - type IIIA, in 7 - type IIIB. The structural features of these implants, made of tantalum in a carbon skeleton with uniform porosity, similar to the structure of bone tissue, provide an increased coefficient of friction, thereby contributing to the rapid growth of bone tissue in the implant structure. Results. The average follow-up period was 14 months. The average preoperative assessment of the hip joint by Harris Hip Score (HHS) was 43 points (from 14 to 86). After surgery, the average HHS improved to 88.7 (69 to 100). 1 patient had hemorrhagic discharge after surgery. On the 7th day an audit was performed. In 2 cases, paresis of the peroneal portion of the sciatic nerve developed after surgery. There were no cases of recurrent dislocations, deep infection, pulmonary embolism or death as a result of operations. Conclusion. Taking into account the mechanical properties, tantalum implants allow to achieve a stable primary fixation with the restoration of the center of rotation of the hip joint and eliminate the risks associated with the use of allografts. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

scholarly journals High- Versus Low-Energy Acetabular Fracture Outcomes in the Geriatric Population

2020 ◽  
Vol 11 ◽  
pp. 215145932093954 ◽  
Author(s):  
Alexa Cecil ◽  
Jonathan W. Yu ◽  
Viviana A. Rodriguez ◽  
Adam Sima ◽  
Jesse Torbert ◽  
...  
Keyword(s):  
Older Adults ◽  
Acetabular Fracture ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
High Energy ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Heterotopic Bone ◽  
Geriatric Population ◽  
Energy Group

Introduction: High-energy mechanisms of acetabular fracture in the geriatric population are becoming increasingly common as older adults remain active later in life. This study compared outcomes for high- versus low-energy acetabular fractures in older adults. Materials and Methods: We studied outcomes of 22 older adults with acetabular fracture who were treated at a level-I trauma center over a 4-year period. Fourteen patients were categorized as low-energy mechanism of injury, and 8 were identified as a high-energy mechanism. We analyzed patient demographics with univariate logistic regressions performed to assess differences in high- and low-energy group as well as patient characteristics compared with surgical outcomes. Results: Most high-energy mechanisms were caused by motor vehicle collision (n = 4, 50.0%), with most having posterior wall fractures (50.0%). Among patient characteristics, the mechanism of injury, hip dislocation, fracture types, and fracture gap had the largest differences between energy groups effect size (ES: 2.45, 1.43, 1.36, and 0.83, respectively). The high-energy group was more likely to require surgery (odds ratio [OR] = 2.80, 95% CI: 0.26-30.70), develop heterotopic bone (OR = 4.33, 95% CI: 0.33-57.65), develop arthritis (OR = 3.60, 95% CI: 0.45-28.56), and had longer time to surgery (mean = 4.8 days, standard deviation [SD] = 5.8 days) compared to low-energy group (mean = 2.5 days, SD = 2.3 days). Discussion: The results of this case series confirm previous findings that patients with high-energy acetabular fractures are predominantly male, younger, and have fewer comorbidities than those who sustained low-energy fractures. Our results demonstrate that the majority of the high-energy fracture patients also suffered a concurrent hip dislocation with posterior wall fracture and experienced a longer time to surgery than the low-energy group. Conclusion: Geriatric patients who sustained high-energy acetabular fractures tend to have higher overall rates of complications, including infection, traumatic arthritis, and heterotopic bone formation when compared with patients with a low-energy fracture mechanism.

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