Acute total hip arthroplasty for anterior hip fracture–dislocation: a case report

TL;DR

This case report describes successful acute total hip arthroplasty for a rare anterior hip fracture-dislocation in an elderly patient.

Contribution

The paper presents a novel case of acute THA for a rare injury pattern with favorable outcomes.

Findings

Acute THA via a posterior approach was successfully performed without additional internal fixation.

The patient resumed recreational sports with a high Harris Hip Score at 6 months post-surgery.

Acute THA may be a viable option for selected anterior hip fracture–dislocations.

Abstract

Hip fracture–dislocations accompanied by femoral head or acetabular fractures remain challenging, and the optimal treatment strategy is still controversial. Anterior hip fracture–dislocations are particularly rare, and reports describing acute total hip arthroplasty (THA) for this injury pattern are limited. We report the case of a 74-year-old active woman who sustained an anterior hip fracture–dislocation with femoral head and acetabular anterior wall fractures after a low-energy fall. The injury was classified as Pipkin type IV and Brumback type 4B. Following closed reduction, acute THA was performed via a posterior approach using a dual mobility cup without additional internal fixation, as adequate acetabular coverage and primary stability were achieved intraoperatively. Immediate full weight-bearing was allowed. At 6 months postoperatively, the patient had resumed recreational sports, with a Harris Hip Score of 92 and no complications. Acute THA may be a viable treatment option for selected anterior hip fracture–dislocations.

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