scholarly journals Concomitant posterior hip dislocation, ipsilateral intertrochanteric- and proximal tibial- fractures with popliteal artery injury: a challenging trauma mélange

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Pranit N. Chotai ◽  
Nabil A. Ebraheim ◽  
Ryan Hart ◽  
Andrew Wassef
Keyword(s):  
Popliteal Artery ◽  
Tibial Fracture ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Postoperative Outcome ◽  
Activity Level ◽  
Artery Injury ◽  
Posterior Hip Dislocation

Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome.

Post-traumatic bilateral posterior hip dislocations with femoral head fracture on one side and acetabular fracture on the other side: a very rare presentation

2021 ◽  
Vol 14 (1) ◽  
pp. e239339
Author(s):  
Atmananda Hegde ◽  
Prajwal Prabhudev Mane ◽  
Vikrant Khanna ◽  
Seetharama Rao
Keyword(s):  
High Speed ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Hip Dislocation ◽  
High Energy ◽  
Contralateral Side ◽  
Definitive Treatment ◽  
Early Recovery ◽  
Rare Presentation ◽  
Posterior Hip Dislocation

Hip dislocations are common orthopaedic emergencies which need early intervention to have a better outcome. They usually occur as a result of high energy trauma with motor vehicle accidents being the most common cause followed by fall from height. Posterior hip dislocation is more common than anterior. However, bilateral hip dislocations are rare compared with unilateral. Here we report our case with bilateral posterior hip dislocation with one side having head of femur fracture and contralateral side acetabulum fracture. Both hips were reduced under general anaesthesia on the same day of the trauma. Staged definitive treatment was carried out. The patient had an early recovery with no complications. This case represents an unusual, type of injury resulting from a high speed motor vehicle accident. Early diagnosis, immediate resuscitation and reduction of the hip joints followed by a careful and planned definitive treatment is necessary to have a better outcome.

scholarly journals Management of Recurrent Posterior Hip Dislocation in a Down Syndrome Patient with Dysplastic Hip Using Ganz Periacetabular Osteotomy: Follow Up After 4 Years

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
Ismail H. Dilogo ◽  
Jessica Fiolin
Keyword(s):  
Down Syndrome ◽  
Periacetabular Osteotomy ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Syndrome Patient ◽  
Down Syndrome Patient ◽  
Dysplastic Hip ◽  
Posterior Hip Dislocation

Recurrent hip dislocation in a Down Syndrome patient with dysplastic hip is a very challenging case to treat even for an expert orthopaedic hip surgeon. Least compliant patient and family, lowly educated with low socioeconomic status and the dysplastic hip forces limited option as a treatment. This is the first case world wide reporting 4 year follow up of dysplastic hip with Down Syndrome treated successfully with PAO technique. Methods: An eighteen years old female with history of Down Syndrome had multiple posterior hip dislocation episodes since 3 years prior. Several attempts of close reduction and hip spica applications were performed upon dislocation despite no successful retaining of reduction. Acetabular index of right hip were 550 and epiphyseal plate hasclosed. PatientwasperformedopenreductionusingSouthern-Mooreposteriorapproachand osteotomy of ischium, continued with capsulorrhaphy followed with Smith-Peterson anterior approach and osteotomy of superior ramus pubis and iliac bone. Then, derotation maneuver was performed under image intensifier to obtain adequate coveragefollowedwithbonegraftandfixationusing2cannulatedscrewandhipspica castapplication. Results: Within four years after surgery, the hip has never been dislocated again, patient could sit without pain and walk with full weight bearing although Harris Hip Score could not be performed due to Down Syndrome. Leg length discrepancy was negligible,fracture has fully united and acetabularin dex was300. Conclusions: Ganz periacetabular osteotomy, although a technically demanding surgery, is a preferable treatment in recurrent hip dislocation for Down Syndrome patient with good to excellent clinical and radiological ou tcome

scholarly journals Stroke Secondary to Traumatic Carotid Artery Injury – A Case Report

2018 ◽  
Vol 4 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Zoltán Bajkó ◽  
Smaranda Maier ◽  
Anca Moțățăianu ◽  
Rodica Bălașa ◽  
Smaranda Vasiu ◽  
...  
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Ischaemic Stroke ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Duplex Ultrasound ◽  
Optimal Dose ◽  
High Morbidity ◽  
Carotid Artery Injury ◽  
Artery Injury

AbstractIntroduction:Lesions of the carotid and vertebral arteries secondary to direct trauma, called blunt cerebrovascular injuries (BCVI) are relatively rare and are markedly different from spontaneous dissections. Ischaemic stroke is a significant complication, with high morbidity and mortality rates. The basis of a diagnosis relies on appropriate, high sensitivity imaging screening.Case report: We present the case of a 31 years old male patient with polytraumatism secondary to a motor vehicle accident, who was admitted to an orthopaedic clinic for multiple lower extremity fractures. His fractures were treated surgically. He developed in the 3rd day after the admission left sided hemiparesis secondary to ischaemic stroke. The diagnosis of traumatic carotid artery injury (TCAI) was based on duplex ultrasound and angio CT scans. The outcome was favourable despite the severe carotid lesions presenting with occlusion secondary to dissection.Conclusions: In the majority of BCVI cases there is a variable latent period between the time of injury and the development of stroke. The management of cases is challenging because in the majority of cases there are multiple associated injuries. Although antithrombotics are widely used in the treatment, there is no consensus regarding the type of agent, the optimal dose or treatment duration.

scholarly journals Periprosthetic tibial fracture after total knee arthroplasty with popliteal artery injury—A case report

2020 ◽  
Vol 30 ◽  
pp. 100359
Author(s):  
Hironobu Konishi ◽  
Naoki Maegawa ◽  
Satoko Nakao ◽  
Keisuke Masuda ◽  
Akinori Okuda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Popliteal Artery ◽  
Tibial Fracture ◽  
Artery Injury ◽  
Total Knee

scholarly journals A Rare Case of a Traumatic Posterior Hip Dislocation in a 3-Year-Old Boy: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jan-Dierk Clausen ◽  
Marcel Winkelmann ◽  
Christian Macke ◽  
Philipp Mommsen ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Femoral Head ◽  
Rare Case ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Early Mobilization ◽  
Minor Trauma ◽  
Review Of The Literature ◽  
Early Osteoarthritis ◽  
Traumatic Hip Dislocation ◽  
Posterior Hip Dislocation

We present a rare case of neglected hip dislocation in a 3-year-old boy. Hip dislocations in childhood represent less than 6% of all injuries. The boy presented to the ED with ongoing hip pain after his leg got stuck in a carousel. The physical and radiologic examination revealed a posterior right hip dislocation. The closed reduction failed, so open reduction during surgery was performed. The postoperative protocol included 3 days of immobilization with early mobilization and pain-adapted weight bearing. No signs of femoral head malperfusion occurred 2 months after the injury. The patient did not complain of any limitations such as weight bearing problems or loss of range of motion. In comparison to adults, there are several specialties such as the fact that minor trauma can lead to hip dislocations due to the laxity of the ligaments, and due to the limited direct anamnestic options, neglected hip dislocations can occur. The treatment should focus on immediate proper reduction. The main complications after traumatic hip dislocation are avascular necrosis of the femoral head, redislocation, and early osteoarthritis.

Bilateral Traumatic Hip Dislocation Associated with Sacro-Iliac Dislocation

2002 ◽  
Vol 12 (1) ◽  
pp. 47-49
Author(s):  
L. Galois ◽  
E. Meuley ◽  
F. Pfeffer ◽  
D. Mainard ◽  
J.P. Delagoutte
Keyword(s):  
Closed Reduction ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Hip Dislocation ◽  
High Energy ◽  
Skeletal Traction ◽  
Rare Injury ◽  
Traumatic Hip Dislocation ◽  
Vehicle Accident

We report a rare injury in an 18-year-old woman who sustained posterior bilateral hip dislocation with sacro-iliac dislocation after a high energy motor vehicle accident. She was treated by closed reduction and skeletal traction. Bilateral traumatic hip dislocation is an uncommon occurrence. Rarer still is bilateral traumatic hip dislocation associated with sacro-iliac dislocation because it combines two different mechanisms of trauma.

scholarly journals Early Rehabilitation Following Surgical Fixation of a Femoral Shaft Fracture

2006 ◽  
Vol 86 (4) ◽  
pp. 558-572 ◽  
Author(s):  
Mark V Paterno ◽  
Michael T Archdeacon ◽  
Kevin R Ford ◽  
Doug Galvin ◽  
Timothy E Hewett
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Femur Fracture ◽  
Functional Limitations ◽  
Weight Bearing ◽  
Knee Extensor ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Left Femur ◽  
Hip Abductor

Abstract Background and Purpose. The purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluation-based, immediate-weight-bearing approach to rehabilitation. Case Description. The patient was a 28-year-old male manual laborer whose left femur was fractured in a head-on motor vehicle accident. The patient was treated with internal fixation of the left femur by use of an antegrade intramedullary nail. Following surgery, impairments in range of motion, knee extensor and hip abductor strength, and gait were observed. Intervention focused on immediate weight bearing and early progression of strengthening to address the observed impairments. Outcomes. All of the patient’s impairments improved, and he was able to return to work as a manual laborer within 6 months. Discussion. Immediate weight bearing with early strengthening activities following surgical correction of a midshaft femur fracture may result in early resolution of impairments and functional limitations and decreased disability.

scholarly journals Use and Evaluation of Patient-Specific Titanium Implant for Delayed Repair of Posttraumatic Frontonasoethmoidal and Supraorbital Bone Defect

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1601483 ◽  
Author(s):  
Abd Jabar Nazimi ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rifqah Nordin
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Postoperative Outcome ◽  
Titanium Implant ◽  
Patient Specific ◽  
Reference Database ◽  
Reconstruction Method ◽  
Postoperative Result ◽  
Vehicle Accident ◽  
Planning Software

A 53-year-old female patient was referred to us with a posttraumatic frontoorbital deformity following motor vehicle accident after 2 months of her injury. Using the virtual surgical planning software, comprehensive analysis of the deformity, and preoperative planning was simulated. The reconstruction of the defect was then determined and approximated to the skull of the reference database. Patient-specific implant is manufactured by selected laser melting of titanium powder grade 2, which yielded a highly accurate personalized implant. The good postoperative outcome was satisfactorily achieved. The postoperative result was also comparable to the predicted outcome as showed via chromatographic analysis method. Not only being less invasive, the operative time was also remarkably reduced as compared with the conventional reconstruction method of similar cases.

scholarly journals ASYMMETRICAL DISLOCATION OF BILATERAL HIP IN AN ADOLESCENT

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
Terence ◽  
TS Tan ◽  
S Jagjoth ◽  
N. Yogeshwaran
Keyword(s):  
Lower Limb ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Hip Dislocation ◽  
Long Bone ◽  
Common Mechanism ◽  
Rare Injury ◽  
Masquelet Technique ◽  
Pelvic Radiograph ◽  
The Right

Hip joint being an inherently stable joint requires a significant amount of force to dislocate. Different mechanism of injury causing different pattern of dislocation. We presented a rare injury of simultaneous asymmetrical dislocation of bilateral hip in an adolescent patient following motor vehicle injury. Presentation: 15 years old girl, pillion rider sustained a motor vehicle accident whereby she was thrown forward with her right hip adducted and flexed, the knee hit on the motorcycle bumper and her left hip in abduction and knee in flexion hit on the road divider. On admission her left lower limb was flexed, abducted, and externally rotated; in contrast, the right lower limb was flexed, adducted, and internally rotated. A pelvic radiograph (figure1) revealed bilateral hip dislocation with the femoral head displaced antero-inferiorly on the left side and posteriorly on the right side. Closed reduction of the joints was done under sedation and subsequently put on traction. Repeated radiograph showed both hip joints well reduced (Figure 2), skin traction was applied for 5 days and subsequently she was allowed for wheelchair ambulation. [Figure: see text][Figure: see text] Discussion: Bilateral simultaneous hip dislocations are an extremely rare injury (1.25%)1, however bilateral asymmetric dislocations of hip are even rarer. Based on described mechanisms, they ranged from pedestrian being hit by a car to head on collision of vehicles and motorcycle crash. The single common mechanism involved in most of these cases was a sudden deceleration injury which occurred in motor vehicle accidents. Treatment for asymmetrical dislocations are still similar, with concentric reduction still the main goal either closed or open reduction. Conclusion: Asymmetric bilateral hip dislocation is a rare entity especially in adolescents and requires high velocity collision with sudden deceleration injury. Reference: Management of shotgun induced open fractures of the humerus with Ilizarov fixator;2015 The Masquelet Technique for Thumb Metacarpal Reconstruction Following Trauma ; JBJS; 2018 Muscle reconstruction in reconstructive surgery: soft tissue repair and long bone reconstruction; 2003

Asymmetric Bilateral Hip Fracture-Dislocation: A Case Report and Literature Review

2020 ◽  
Author(s):  
Seyed Mohammad Javad Mortazavi ◽  
Hamed Mazzochy ◽  
Mohammad Ali Ghasemi ◽  
Furqan Mohammed Yaseen Khan
Keyword(s):  
Case Report ◽  
Hip Fracture ◽  
Femoral Head ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Hip Dislocation ◽  
Rare Condition ◽  
Initial Step ◽  
Fracture Dislocation ◽  
Femoral Head Fracture

Background: Asymmetric bilateral hip dislocation is a rare condition, especially when it is accompanied by a bilateral femoral head fracture. Case Report: A 28-year-old man who sustained a motor vehicle accident, was presented to the our center (Imam Khomeini Hospital Complex) with asymmetric bilateral hip fracture-dislocation. In the initial step, closed reduction was performed, followed by bilateral open reduction and fixation of the femoral head fragment by screws. The results were satisfactory after 5 years of follow-up. Conclusion: Although rare, paradoxical femoral head fracture should be considered in patients with hip dislocation. We recommend our therapeutic approach in a similar situation.

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