PMC6051121_01
Radiographs of the pelvis (a), showing a posterior wall acetabulum fracture (b) with a displaced femoral head and a concomitant femur shaft fracture (c).
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He also had an ipsilateral femoral neck fracture with the femoral head displaced anteriorly (Figures 1(a) and 1(b)) and also an associated middle-third fracture of the shaft of the femur (Figure 1(c)).
Intraoperative images of the displaced femoral head (a) which was reduced and fixed following the acetabulum fixation (b, c, d). Postoperative radiograph (e).
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Upon dissection, the femoral head (Figure 2(a)) was found to have buttonholed and displaced anteriorly through the capsule which was found to be torn. The posterior wall of the acetabulum was addressed using two contoured reconstruction plates (Figure 2(b)). The femoral head fracture and the shaft fracture were fixed with an antegrade femoral nail with two screws securing the femoral head (Figures 2(c) and 2(d)).
Anterior dislocation of the hip joint (a, b) following an episode of myoclonus which was managed by open reduction (c).
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He presented to us with an anterior dislocation of the left hip joint (Figures 3(a) and 3(b)). An open surgery was done to reduce the left hip joint (Figure 3(c)).
Avascular necrosis of the left femoral head (a) which was managed by implant removal and left total hip replacement (b) after union of the femur shaft fracture.
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As expected, avascular necrosis of the femoral head occurred (Figure 4(a)) and we waited for union of the femoral shaft to occur as any procedure to address the femoral head would require removal of the intramedullary nail. The acetabulum was reconstructed using a cage, and an uncemented hydroxyapatite-coated stem was used for the femur (Figure 4(b)).