Anterior Hip Fracture Dislocation with Intrapelvic Retention of the Femoral Head and Ureter Fistula

 

What to Learn from this Article?

Management and Decision Making in a Complex Situation.


Case Report |  Volume 4 | Issue 3 | JOCR July-Sep 2014 | Page 40-42 | Patrascanu C,  Cibu D.  DOI: 10.13107/jocr.2250-0685.193


Authors: Patrascanu C[1],  Cibu D[2]

[1] Department of Orthopaedic Surgery, Bd Revolutiei 20 . Alba  Iulia , Romania.

[2] Department of Urology, Alba District Hospital, Bd. Revolutiei 20, Alba Iulia, Romania.

Address of Correspondence:

Dr. Calin Patrascanu. Str. Traian 48c, 510109  Alba Iulia, Romania. E-mail: calinpatrascanu@yahoo.com


Abstract

Introduction: The anterior dislocation of the hip represents only a small percentage of all hip dislocations: 85% are posterior. Most commonly associated with this dislocation is a fracture of the femoral head and, in rare cases, a femoral neck fracture. We have found in literature no report of an anterior dislocation of the hip associated with femoral neck fracture, pelvic retention of the head and ureteral fistula. We report such a case of a 68 year old male.

Case Report: A 68 year old male was presented to our attention, following a severe injury of the hip when falling from a high bridge, with severe pain in the hip and a clinical aspect of femoral neck fracture. The X-ray confirmed the femoral neck fracture but following an anterior dislocation with the head retained into the pelvis. The patient also had hematuria. An Austin Moore prosthesis was implanted for the femoral neck fracture and the head was extracted by the urologist by a new abdominal incision. Urological evaluation revealed a fistula of the ureter, treated by an internal drainage for three months. One month later the Moore prosthesis was extracted and the patient had a Girldestone hip for 5 months. Revision with a Muller cemented prosthesis had a normal evolution.

Conclusion: The anterior fracture dislocation of the hip with pelvic retention of the femoral head and ureteral fistula is a rare condition resulting from high energy trauma. A multidisciplinary team is necessary to diagnose and treat fracture and soft tissue lesions. Early diagnosis and treatment is necessary to avoid   septic complications.

Keywords: Hip dislocation, anterior, femoral neck fracture, ureteral fistula, adult, surgical treatment.


How to Cite This Article: Patrascanu C,  Cibu D. Anterior Hip Fracture Dislocation with Intrapelvic Retention of the Femoral Head and Ureter Fistula. Journal of Orthopaedic Case Reports 2014 July-Sep;4(3): 40-42. Available from: http://www.jocr.co.in/wp/2014/07/11/2250-0685-193-abstract/

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