PMC5451766_01
Computed tomography suggested a bone chip from the posterior wall of the acetabular roof and a depressed femoral head that cut into the posterior margin of the acetabular roof.
CRIOR2017-7409153.001.jpg
PMC5451766_01_CRIOR2017-7409153.001.jpg
fig1
Plain X-ray revealed posterior dislocation of the hip, and, on CT, not only was a posterior wall bone fragment measuring 24 mm x 10 mm x 3 mm visible, but the posterior margin of the acetabulum had created a depression in the femoral head into which it was impacted (Figure 1).
Computed tomography of the left hip joint after reduction.
CRIOR2017-7409153.002.jpg
PMC5451766_01_CRIOR2017-7409153.002.jpg
fig2
Emergency manual reduction was performed on the same day under general anesthesia (Figure 2).
Computed tomography of the left hip joint after redislocation.
CRIOR2017-7409153.003.jpg
PMC5451766_01_CRIOR2017-7409153.003.jpg
fig3
He was discharged home on day 26, but 4 days after discharge, when he was climbing down a step with his right leg, his left hip again became dislocated posteriorly in a manner similar to the initial injury, and he was readmitted to hospital (Figure 3).
Removed femoral head. The depressed fracture in the femoral head is observed.
CRIOR2017-7409153.004.jpg
PMC5451766_01_CRIOR2017-7409153.004.jpg
fig4
Manual reduction was again attempted, but because the hip dislocated easily, total hip arthroplasty was performed (Figures 4 and 5), and the patient's subsequent course has been uneventful even 1 year after the surgery.
Radiographs of the hip joint after total hip arthroplasty.
CRIOR2017-7409153.005.jpg
PMC5451766_01_CRIOR2017-7409153.005.jpg
fig5
Manual reduction was again attempted, but because the hip dislocated easily, total hip arthroplasty was performed (Figures 4 and 5), and the patient's subsequent course has been uneventful even 1 year after the surgery.