Severe pelvic trauma: hip dislocation with bilateral femoral fractures
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There is a vertically orientated 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.
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 orthopaedic emergency, and closed reduction is favoured within 6 hours of diagnosis. Fractures that cannot be reduced should be considered for open reduction 1-3.
- 1. Hougaard K, Thomsen PB. Traumatic posterior fracture-dislocation of the hip with fracture of the femoral head or neck, or both. J Bone Joint Surg Am. 1988;70 (2): 233-9. Pubmed citation
- 2. Roeder LF, DeLee JC. Femoral head fractures associated with posterior hip dislocation. Clin. Orthop. Relat. Res. 1980; (147): 121-30. Pubmed citation
- 3. Ross JR, Gardner MJ. Femoral head fractures. Curr Rev Musculoskelet Med. 2012;5 (3): 199-205. doi:10.1007/s12178-012-9129-8 - Free text at pubmed - Pubmed citation