PMC7276619_01
Plain radiograph before manipulation and reduction.
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F1
When brought to the local hospital, plain radiograph showed a right posterior hip dislocation associated with a femoral head fracture (Fig. 1).
Plain film post-manoeuver and reduction showing displaced femoral head fracture.
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F2
Manipulation and reduction (M and R) were attempted, approximately within 6 h to injury, to relocate the right hip and subsequent post M and R radiographs showed iatrogenic fracture of the femoral neck (Fig. 2).
Pre-operative transverse cut computed tomography scan showing fracture-dislocation of femoral head.
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F3
An urgent computed tomographic scan was done which showed a fracture-dislocation of the right hip (Fig. 3).
Comminuted femoral head fracture.
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F4
The fracture line ran inferior to the fovea separating a main superior and grossly comminuted inferior fragment (Fig. 4 and 5).
Comminuted femoral head fracture (temporary reduction).
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F5
The fracture line ran inferior to the fovea separating a main superior and grossly comminuted inferior fragment (Fig. 4 and 5).
Post-operative films showing femoral head fracture fixation.
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F6
The femoral head was then reduced within the acetabulum and the trochanteric flip osteotomy was fixed usingheadless and cortical screws (Fig. 6).
Plain radiograph showing avascular necrosis of the femoral head with progressive shrink and collapse.
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F7
Plain radiographs showed avascular necrosis of the femoral head with progressive shrink and collapse (Fig.7), resulting in prominent compression screws abutting against the acetabulum.
Plain radiograph post-right total hip arthroplasty.
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F8
Given the clinical picture, we counseled the patient for the removal of implants and conversion to the right total hip arthroplasty (Fig.8).The patient underwent surgery uneventfully.