Posterior hip dislocation and ipsilateral isolated femoral neck fracture: A novel fixation method

Abstract

It is accepted that a traumatic hip dislocation is a surgical emergency, this holds for the uncommon dislocation of the hip with femoral neck fracture however the surgical dilemma involves head salvage or replacement. This case report describes the method and technique for stabilisation of the rare and challenging isolated posterior hip dislocation with an ipsilateral femoral neck fracture. A 38-year-old gentleman was involved in a high-speed road traffic collision sustaining a posterior dislocation with ipsilateral femoral neck fracture. This was managed emergently with open reduction and osteosynthesis. The technique was by the modified placement of three cannulated screws through a posterior approach. The use of antegrade guide wires allowed accurate placement in a triangular configuration and temporary fixation to facilitate hip reduction prior to retrograde insertion of three 6.5mm cannulated screws. The patient, although developing radiological avascular necrosis, continues to work and has returned to hobbies at 4.5 years.

Fig. 1

Posterior dislocation of the femoral head with no associated acetabular fracture

Fig. 2

Posterior dislocation of the femoral head with no associated acetabular fracture

Fig. 3

Posterior dislocation of the femoral head with no associated acetabular fracture

Fig. 4

No early displacement or evidence of avascular necrosis

Fig. 5

Presence of avascular necrosis