PMC4845411_01
Anteroposterior radiographs of the pelvis.
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F1
Radiographic assessment of the pelvis revealed a left obturator dislocation of the femoral head (Fig. 1A). In addition, a small, comminuted, minimally displaced anterior acetabular wall fracture was also identified but was not amenable to fixation (Figs. 1A-1B and 2). Post-operative radiographs demonstrated an anatomic reconstruction of the articulating surface of the femoral head (Figs. 1C-D).
Computed tomography (CT) scans performed after closed reduction.
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F2
In addition, a small, comminuted, minimally displaced anterior acetabular wall fracture was also identified but was not amenable to fixation (Figs. 1A-1B and 2).
Intraoperative view of the femoral head after surgical dislocation of the left hip
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F3
Once the allograft fragment was appropriately reduced, it was provisionally secured with two .062 in Kirschner (K)-wires (Fig. 3C). Following confirmation of the reduction using the image intensifier, the graft was secured to the native femoral head with two countersunk 2.7mm cortical lag screws (Fig. 3D).
Postoperative anteroposterior and iliac oblique radiographs of the left hip and pelvis
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F4
Direct visualization of the femoral head revealed a comminuted impaction type fracture that was consistent in size and shape with the defect identified on pre-operative imaging studies (25 x 10 mm, thickness: 5 mm) that was located on the posterosuperior weight bearing area near the head-neck junction (Figs. 4A-4B). Radiographs demonstrated a concentric hip joint with interval healing without evidence of collapse, implant loosening, implant failure or secondary arthritis (Fig. 4).