J Korean Fract Soc.  2007 Jan;20(1):94-98. 10.12671/jkfs.2007.20.1.94.

Hip Fracture-dislocation with Sciatic Nerve Palsy and Ipsilateral Femoral Shaft Open Fracture: A Case Report

• Kim KJ
• Kim HY
• Kang SI
• Choy WS

• KMID: 2294387
• DOI: http://doi.org/10.12671/jkfs.2007.20.1.94

Abstract

The posterior dislocation of the hip accounts for about 85~90% of traumatic hip dislocations and high energy mechanisms such as traffic accidents may cause them. The traumatic dislocation and fracture-dislocation of the hip are true orthopedic emergencies and it should be considered that a femoral head has poor vascularity and the sciatic nerve is closely located to it. We report on one patient who went through the surgical treatment of the concomitant ipsilateral open fracture of the femoral shaft and hip fracture-dislocation accompanying sciatic nerve injury with the review of the literatures.

Keyword

Hip joint; Sciatic nerve; Femur; Fracture-dislocation

MeSH Terms

Accidents, Traffic
Dislocations
Emergencies
Femur
Fractures, Open*
Head
Hip Dislocation
Hip Joint
Hip*
Humans
Orthopedics
Sciatic Nerve*
Sciatic Neuropathy*

Figure

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  Fig. 1 Initial radiograph shows posterior hip dislocation and posterior wall fracture of acetabulum.

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  Fig. 2 (A, B) Initial radiographs show femoral shaft fracture and displaced butterfly fragment. (C) Medical photograph shows open wound of anterior thigh and tented soft tissue.

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  Fig. 3 CT scan shows posterior hip dislocation and fracture fragment of posterior wall of acetabulum.

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  Fig. 4 (A) Intraoperative photograph shows dislocated femoral head, acetabular posterior wall fractured fragment and sciatic nerve. The continuity of sciatic nerve is intact but attenuated. (B) Intraoperative photograph shows reduced femoral head and posterior wall of acetabulaum.

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  Fig. 5 Immediate postoperative radiograph shows reduction of hip dislocation and plate fixation of acetabular wall.

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  Fig. 6 Immediate postoperative radiographs show reduction of fractured femur and external fixator is applied.

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  Fig. 7 External fixation of femur is converted to internal fixation with retrograde intramedullary nail.

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  Fig. 8 Eight months follow up radiographs show complete union of posterior acetabular wall (A) but nonunion of femoral shaft (B, C).

Reference

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