Irreducible traumatic pure hip dislocation by the entrapment of the lateral rotator muscle group of the hip: A case report.

Introduction: Irreducibility is a rare complication of pure posterior hip dislocation requiring surgical intervention. Case presentation: We present a case of a 22-year-old female with posterior hip dislocation following a motor vehicle accident. Despite unsuccessful closed reduction attempts, open surgical reduction successfully released the incarcerated muscles and achieved reduction. Follow-up examinations showed excellent functional outcomes without complications. Clinical discussion: Irreducibility remains a rare complication of traumatic posterior hip dislocation. Three possible entities can cause soft tissue incarceration: labral buttonholing, intra-articular osteochondral bodies, and entrapment of the piriformis muscle. The posterior-lateral approach provides excellent exposure of the posterior hip structures, but it carries the risk of injury to the medial circumflex artery. After successfully reducing the dislocation, it is essential to perform a computed tomography (CT) scan to detect any osteochondral lesions, including femoral head impaction. Functional outcomes are better with early mobilization and prompt resumption of weight-bearing. However, femoral head osteonecrosis complicates 52.9 % of hip dislocations reduced beyond 6 h, whereas it occurs in only 4.8 % of dislocations reduced within this timeframe. Conclusion: This case underscores the importance of prompt recognition and appropriate surgical intervention for irreducible hip dislocations to prevent further complications and optimize patient outcomes.

Bilateral acetabular fractures (case report).

INTRODUCTION AND IMPORTANCE: Bilateral acetabular fractures are very rare. They are usually seen in the context of multiple trauma patients. This type of fracture poses a problem and difficulty in therapeutic management, sometimes resulting in serious sequelae and significant morbidity. CASE PRESENTATION: We report a rare case of bilateral simultaneous acetabular fracture in an adult, forty-seven years old man due to a road accident. CLINICAL DISCUSSION: Bilateral acetabular fractures are very rare. While bilateral acetabular fracture most frequently occur due to automobile accidents, other mechanism can be responsible for this injury as well. Furthermore, bilateral acetabular fractures are frequently associated with other lesions of the surrounding bones or tissues. Surgery is the most suitable treatment in most cases. The development of osteoarthritis is the most common complication of acetabular fracture and is directly related to the post-operative reduction obtained. Heterotopic ossifications are a complication associated with acetabular fracture. In acetabular fracture, the primary objective of surgical treatment is anatomical reduction of the fracture that will determinate the future of hip. CONCLUSION: The treatment goal of acetabular fracture is anatomic or near anatomic reduction of the articular surface. The risk of osteonecrosis is mostly related to the initial injury and time to reduction.