Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 13;12(2).
doi: 10.2106/JBJS.CC.22.00062. eCollection 2022 Apr 1.

Irreducible Traumatic Fracture-Dislocation of the Hip with Impalement onto the Ischial Spine: A Case Report

Thomas M Large  1
Affiliations
Case Reports

Irreducible Traumatic Fracture-Dislocation of the Hip with Impalement onto the Ischial Spine: A Case Report

Thomas M Large. JBJS Case Connect. .

Abstract

Case: A 45-year-old man appeared to have a central (protrusio) hip dislocation but actually had a transverse posterior wall acetabulum fracture with irreducible posterior dislocation due to impalement of the femoral head on the ischial spine. He underwent urgent open reduction on presentation and subsequent internal fixation in a staged manner. He developed avascular necrosis at 18 months postoperatively.

Conclusion: The nondisplaced ilioischial and iliopectineal acetabular radiographic lines were alerts that the dislocation was actually posterior. This led to further imaging before any closed reduction attempts because standard reduction maneuvers would have placed the patient at high risk for iatrogenic femoral head or neck fracture.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B837).

References

    1. Garrett JC, Epstein HC, Harris WH, Harvey JP, Nickel VL. Treatment of unreduced traumatic posterior dislocations of the hip. J Bone Joint Surg Am. 1979;61(1):2-6.
    1. Kellam P, Ostrum RF. Systematic review and meta-analysis of avascular necrosis and posttraumatic arthritis after traumatic hip dislocation. J Orthop Trauma. 2016;30(1):10-6.
    1. Ahmed G, Shiraz S, Riaz M, Ibrahim T. Late versus early reduction in traumatic hip dislocations: a meta-analysis. Eur J Orthop Surg Traumatol. 2017;27(8):1109-16.
    1. Hougaard K, Thomsen PB. Traumatic posterior dislocation of the hip—prognostic factors influencing the incidence of avascular necrosis of the femoral head. Arch Orthop Trauma Surg. 1986;106(1):32-5.
    1. Liporace FA, Dasti UR, Raiszadeh K. Ipsilateral anterior then irreducible posterior hip dislocation without fracture: a case report. J Orthop Trauma. 2008;22(5):363-7.

Publication types

LinkOut - more resources