Severe pelvic trauma (hip dislocation with bilateral femoral fractures)
Presentation
Paragliding accident.
Patient Data
There is a vertically oriented sheer fracture of the medial right femoral head with superior dislocation of the hip joint. Loose bony fragment sits within the acetabular fossa. There is also a left femoral shaft fracture with shortening and comminution.
Case Discussion
Femoral head fractures are uncommon, and are usually the result of high impact trauma. The 'textbook' mechanism is via a posterior dislocation of the hip. The amount of force involved means there is a high chance of significant associated injuries 1,3.
A fracture-dislocation of the hip is defined as an orthopedic emergency, and closed reduction is favored within 6 hours of diagnosis. Fractures that cannot be reduced should be considered for open reduction 1-3.
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