title: Hip dislocation associated with ipsilateral femoral neck and shaft fractures: an unusual combination and dilemma regarding head preservation.
abstract: Traumatic posterior hip dislocation associated with a fracture of the femoral neck is a rare injury. The combination of posterior dislocation of the femoral head with ipsilateral femoral neck and shaft fractures is even rarer, with only one such case reported in literature. We present the case of a 50-year-old man, with traumatic posterior dislocation of the hip, and fractures of the femoral neck and shaft, in addition to an undisplaced superior pubic ramus fracture of the acetabulum. Osteosynthesis of the femoral shaft fracture followed by open reduction of the femoral head and fixation of the neck was undertaken, while taking care not to damage the intact retinaculum on the posterosuperior aspect of the femoral neck. The radiographs revealed union of all fractures without evidence of avascular necrosis of the femoral head at final follow-up of two years. This case is of particular interest as it highlights some of the important factors in deciding between head preservation versus arthroplasty for this complex fracture-dislocation.
authors: Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India.
authors: Gaurav
authors: G
authors: Sharma
authors: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors: Manish
authors: M
authors: Chadha
authors: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors: Amite
authors: A
authors: Pankaj
mesh_terms: D000063:Accidents, Traffic; D001863:Bone Screws; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006617:Hip Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery*; D035583:Rare Diseases; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods