PMC6930723_01
Axial slice of CT abdomen and pelvis with contrast demonstrating intrapelvic dislocation with the left femoral head just posterior to pubic symphysis.
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CT of the abdomen and pelvis was obtained showing a dislocated left hip, with the femoral head displaced into the intrapelvic space compressing the urethra (Figures 1 and 2).
Coronal slice of CT abdomen and pelvis with contrast demonstrating medial displacement of femoral head into the true pelvis with empty acetabulum on the left.
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CT of the abdomen and pelvis was obtained showing a dislocated left hip, with the femoral head displaced into the intrapelvic space compressing the urethra (Figures 1 and 2).
Intraoperative fluoroscopic AP pelvis demonstrating concentric reduction of the left femoral head.
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Instead, longitudinal traction, hip flexion, and external rotation were utilized until an audible clunk was appreciated, and a fluoroscopic image confirmed reduction of the left femoral head (Figure 3).
Postreduction axial slice of CT pelvis without contrast demonstrating concentric reduction of the left femoral head.
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Postoperative radiographs and CT scan showed reduction of the left hip (Figures 4-5).
Postoperative 3D reconstruction from CT pelvis without contrast demonstrating reduced left femoral head without associated femoral fracture.
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Postoperative radiographs and CT scan showed reduction of the left hip (Figures 4-5).
Follow-up AP pelvis radiograph at 9 weeks postinjury demonstrating concentric reduction of the left femoral head with heterotopic ossification without evidence of femoral head collapse.
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Radiographs showed concentric left hip with some irregularity noted in the femoral head concerning for osteonecrosis without femoral head collapse, as well as heterotopic ossification in surrounding soft tissues (Figure 6).
Follow-up AP pelvis radiograph at 4.5 months postinjury demonstrating further heterotopic ossification and some irregularity of the femoral head concerning for osteonecrosis.
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AP pelvis X-ray was obtained which showed maturation of the heterotopic ossification adjacent to the left hip (Figure 7).
T1 axial image from MRI obtained 7 months postinjury demonstrating focal areas of hypointensity within the left femoral head consistent with osteonecrosis.
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MRI of the pelvis was obtained 7 months postinjury, demonstrating focal areas of hypointensity on T1 images within the femoral head and inferior neck consistent with osteonecrosis, without evidence of femoral head collapse (Figures 8 and 9). Metal artifact from the right femur implant limited the ability of the MRI to evaluate the soft tissues in detail.
T1 coronal image from MRI obtained 7 months postinjury demonstrating focal areas of hypointensity within the left inferior femoral neck consistent with osteonecrosis.
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fig9
MRI of the pelvis was obtained 7 months postinjury, demonstrating focal areas of hypointensity on T1 images within the femoral head and inferior neck consistent with osteonecrosis, without evidence of femoral head collapse (Figures 8 and 9). Metal artifact from the right femur implant limited the ability of the MRI to evaluate the soft tissues in detail.