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.

Keywords

• Dislocation
• femur
• femoral neck
• ipsilateral
• fracture

İpsilateral femur boyun ve şaft kırığı ile birlikte olan kalça çıkığı: Sıradışı bir yaralanma ve osteosentez kararı

Abstract

Femur boyun kırığı ile birlikte oluşan travmatik posterior kalça çıkığı nadir bir yaralanmadır. İpsilateral femur boyun ve şaft kırığı ile birlikte femur başı posterior çıkığı ise literatürde geçen tek bir örneği ile daha da nadir bir yaralanmadır. Bu çalışmada, asetabulumda deplase olmayan superior pubik ramus kırığı, travmatik posterior kalça çıkığı, femur boyun ve şaft kırığı olan 50 yaşında erkek bir hastayı değerlendirdik. Femur şaft kırığı osteosentezini takiben femur boyun posterosuperiorundaki sağlam retinakulum korunarak femur başına açık redüksiyon ve femur boynuna fiksasyon yapıldı. Ameliyattan 2 yıl sonraki takipte çekilen grafilerde, femur başında avasküler nekroz gelişmediği ve bütün kırıkların kaynadığı görüldü. Çalışmamızda bu kompleks kırıklı çıkık yaralanmasında artroplasti veya femur başını koruma kararını etkileyen faktörleri değerlendirdik.

Keywords

• Çıkık; femur; femur boynu; ipsilateral; kırık.

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