# Hip dislocation with ipsilateral shaft of femur fracture: A rare case report

## TL;DR

A rare case of hip dislocation and femur fracture in a teenager is reported, highlighting the need for quick, multidisciplinary treatment to avoid complications.

## Contribution

This paper presents a rare clinical case emphasizing the importance of early surgical intervention and multidisciplinary trauma protocols.

## Key findings

- Prompt surgical intervention within 6 hours reduced the risk of avascular necrosis of the femoral head.
- Intramedullary interlocking nailing provided good alignment and stability for the femur shaft fracture.
- The patient achieved non-weight-bearing ambulation within 2 weeks without complications.

## Abstract

Posterior hip dislocation with ipsilateral shaft of femur fracture is a very rare case encountered. This case presents a rare combination of posterior hip dislocation with ipsilateral femoral shaft fracture with head of femur fracture of a sixteen year old male patient following a road traffic accident (RTA). It emphasizes the importance of a multidisciplinary trauma protocol, early imaging, and timely surgical intervention in complex orthopedic injuries.

Patient was presented in the emergency department with complaints of severe pain and deformity in the left hip and thigh, inability to bear weight, and laceration below the left knee. After initial emergency management patient was operated on with closed reduction of the hip and intramedullary interlocking nailing of the femur after 6 h. Postoperatively, skin traction was applied for 2 weeks to prevent re-dislocation of the hip. Successful surgical management with good functional recovery was achieved. At 2 weeks, the patient was ambulatory with non-weight bearing and crutch walking with no complications seen.

This case underscores the need for protocol-driven, multidisciplinary care in adolescent trauma, with emphasis on early intervention and comprehensive assessment for preventing the patient from complications such as avascular necrosis of the femoral head.

Posterior dislocation of the hip with ipsilateral shaft of femur fracture is an uncommon type of injury where early emergency management followed by prompt surgical intervention is required to prevent avascular necrosis of the femur head. Regular follow-up is essential for monitoring and assessment of condition of hip.

•Posterior dislocation of the hip with ipsilateral shaft of femur is a rare injury typically resulting from high-energy trauma.•The condition requires a multidisciplinary approach, and we managed the patient under ATLS protocol and scheduled surgery as early as possible.•Early intervention and prompt surgical intervention (within 6 h) lowers the risk of avascular necrosis of the femoral head.•A temporary external fixator was applied to align the fracture and facilitate closed reduction of the dislocated hip using the Allis maneuver.•Definitive fixation of the femur shaft was done with intramedullary interlocking nailing, leading to good alignment and stability.•Post-operatively, by day 14, the patient was mobilized with non-weight-bearing ambulation under physiotherapy and was discharged without complications.

Posterior dislocation of the hip with ipsilateral shaft of femur is a rare injury typically resulting from high-energy trauma.

The condition requires a multidisciplinary approach, and we managed the patient under ATLS protocol and scheduled surgery as early as possible.

Early intervention and prompt surgical intervention (within 6 h) lowers the risk of avascular necrosis of the femoral head.

A temporary external fixator was applied to align the fracture and facilitate closed reduction of the dislocated hip using the Allis maneuver.

Definitive fixation of the femur shaft was done with intramedullary interlocking nailing, leading to good alignment and stability.

Post-operatively, by day 14, the patient was mobilized with non-weight-bearing ambulation under physiotherapy and was discharged without complications.