Ipsilateral Hip and Knee Dislocation with Open Tibial Fracture: A Case Report of a Limb Threatening Injury

Abstract

Introduction: Hip or knee dislocations are usually treated as a surgical emergency, but ipsilateral hip and knee dislocation should be considered a dual emergency that must be addressed immediately and reduced at the earliest. We present here the sequence of events and the final functional outcome of one such rare injury manages by us.

Case report: A 22-year-old male was involved in a road traffic accident. He presented to the emergency department in 4 h injury time with painful deformities of the right hip and knee, along with Type I open wound right leg with abnormal mobility suggestive of fracture in the ipsilateral leg.

Conclusion: Simultaneous ipsilateral hip and knee fracture-dislocation with open tibial fracture is a rare injury that should be approached as limb-threatening injury and dual orthopedic emergency. We report this case for its rarity and to document that good results can be achieved with early appropriate treatment.

Keywords: Hip dislocation; knee dislocation; open tibia.

Figure 1

Posterior dislocation of the right knee.

Figure 2

Posterior dislocation of the right hip and knee with comminuted distal tibial fracture.

Figure 3

Postreduction computed tomography pelvis shows minor posterior wall fracture with congruent hip.

Figure 4

Magnetic resonance imaging shows posterior cruciate ligament avulsion fracture at tibial attachment, posterolateral corner injury, and lateral collateral avulsion fracture.

Figure 5

X-ray pelvis shows viable femoral head, and X-ray of knee and leg shows stable knee and healed tibial fracture.

Figure 6

Good range of movements at right hip and knee.