Traumatic posterior hip fracture dislocation with ipsilateral intertrochanteric fracture and sciatic nerve palsy in an adult patient

ABSTRACT

We report a case of post-traumatic posterior hip dislocation and fracture associated with ipsilateral intertrochanteric fracture and sciatic nerve palsy in a young adult. Initial treatment consisted of traction and resuscitation. After failure of closed reduction under general anesthesia, traction through Schanz screw in the neck of femur assisted by anterior capsulotomy to deliver the head of femur was done. Open reduction and internal fixation of intertrochanteric fracture with dynamic hip screw was performed. Skeletal traction through proximal tibia was applied for six weeks. Regular follow-up involved examinations to confirm concentric reduction and stability of the hip joint and assess union of the intertrochanteric fracture and posterior wall acetabulum fracture. Postoperative rehabilitation continued until sciatic nerved recovered over one year. Serial X-rays done for four years after injury did not detect any signs of avascular necrosis of the femoral head. Patient has returned to pre-injury level of daily activity