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.

Vascular complications of tibial exostosis: A case of popliteal vein thrombosis.

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.