Post-traumatic bilateral posterior hip dislocations with femoral head fracture on one side and acetabular fracture on the other side: a very rare presentation

Abstract

Hip dislocations are common orthopaedic emergencies which need early intervention to have a better outcome. They usually occur as a result of high energy trauma with motor vehicle accidents being the most common cause followed by fall from height. Posterior hip dislocation is more common than anterior. However, bilateral hip dislocations are rare compared with unilateral. Here we report our case with bilateral posterior hip dislocation with one side having head of femur fracture and contralateral side acetabulum fracture. Both hips were reduced under general anaesthesia on the same day of the trauma. Staged definitive treatment was carried out. The patient had an early recovery with no complications. This case represents an unusual, type of injury resulting from a high speed motor vehicle accident. Early diagnosis, immediate resuscitation and reduction of the hip joints followed by a careful and planned definitive treatment is necessary to have a better outcome.

Keywords: orthopaedics; trauma.

Figure 1

Pelvis with both hips and upper half of femur, radiographs revealing bilateral hip dislocation with left acetabular fracture.

Figure 2

3D CT scan showing the left hip posterior dislocation with undisplaced transtectal acetabular fracture (yellow ring) with grossly displaced posterior wall acetabular fractures (yellow arrow).

Figure 3

(A) 3D CT scan showing left hip posterior dislocation with grossly displaced posterior wall acetabular fractures (yellow arrow). (B) 3D CT scan showing right side posterior hip dislocation with head of femur fracture (Pipkin’s type 2) (yellow arrow).

Figure 4

Postoperative radiographs showing the femoral head and acetabular fixation with concentric reduction of hip joints.

Figure 5

Latest follow-up radiographs showing union of fracture and no evidence of avascular necrosis of the femoral head.

Figure 6

Latest follow-up radiographs showing union of fracture and no evidence of avascular necrosis of the femoral head.

Figure 7

Clinical image showing the patient’s ability to bear full weight on both the lower limbs without any obvious lurch.