Posterior dislocation of the right hip

Case contributed by Dr Chris O'Donnell

Presentation

Motor bike accident, now severe right hip pain and unable to straighten the leg.

Patient Data

Age: 19 years
Gender: Male

Typical appearance of hip dislocation ie the femoral head displaced upwards and posterior to the acetabulum with a fragment of bone projected over the femoral neck representing the sheared off posterior rim of the acetabulum.

Following reduction, CT performed to determine extent of acetabular disruption

CT

The right hip is now reduced and in normal position. Note the large displaced bone fragment posterior to the acetabulum representing the sheared off posterior lip of the acetabulum. Note also the degree of blood and swelling in the buttock musculature (arrow) indicating the severity of injury and forces required to dislocate the hip.

Case Discussion

CT is important to perform following reduction in order to confirm complete joint reduction, exclude intra-articular bone fragments, clearly define acetabular rim fracture fragments so that surgical repair can be undertaken in order to reduce the likelihood of instability and to exclude associated disruption of the femoral head.

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