title: Avulsion fracture of the ischium following complex total hip arthroplasty: an unusual cause of hip pain.
abstract: Total hip arthroplasty in the high riding dislocated hip is a technically difficult undertaking, with major reconstruction required on both the acetabular and femoral sides. With reconstruction at a near-anatomic hip center, reduction of the arthroplasty is difficult because of the long-standing limb shortening. The major block to reduction is tension of the soft tissues, particularly the hamstrings. We report a case of ischial tuberosity avulsion fracture following such a complex reconstruction despite femoral shortening subtrochanteric osteotomy. This illustrates the importance of the hamstring group in maintaining the dislocation and emphasizes the need to prevent overtension of the soft tissues in such complex reconstructive procedures.
authors.affiliation: Royal Australasian College of Surgeons, Princess Elizabeth Orthopaedic Centre, Exeter, United Kingdom.
authors.forename: P N
authors.initials: PN
authors.lastname: Smith
authors.forename: G A
authors.initials: GA
authors.lastname: Gie
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006618:Hip Dislocation, Congenital / Q000601:surgery; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D007512:Ischium / Q000293:injuries*