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JBJS Case Connect ; 10(4): e20.00104, 2020 12 24.
Article in English | MEDLINE | ID: mdl-33449552

ABSTRACT

CASE: We describe a case of posterior hip dislocation in a 13-year-old boy after a contact football injury with attempted closed reduction resulting in complete separation of the epiphysis from the femoral neck metaphysis with associated femoral head fracture and posterior dislocation of the femoral head. Treatment was emergently performed with a greater trochanteric osteotomy, open reduction internal fixation using cannulated screws, and additional small diameter drill holes in the femoral head to promote blood flow. The patient did well postoperatively and at over 4 years follow-up had no evidence of avascular necrosis and returned to full athletics participation. CONCLUSION: Particular attention should be taken when reducing hip dislocations in the adolescent population who may be predisposed to epiphysiolysis. Preservation of periosteal soft-tissue attachments and the use of small diameter drill holes to promote femoral head blood flow may have contributed to the excellent outcome.


Subject(s)
Epiphyses, Slipped/etiology , Fracture Fixation, Internal/methods , Hip Dislocation/complications , Salter-Harris Fractures/etiology , Adolescent , Epiphyses, Slipped/diagnostic imaging , Epiphyses, Slipped/surgery , Football/injuries , Hip Dislocation/diagnostic imaging , Hip Dislocation/surgery , Humans , Male , Salter-Harris Fractures/diagnostic imaging , Salter-Harris Fractures/surgery , Tomography, X-Ray Computed
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