Obturator Dislocation of Hip with Ipsilateral Fracture Neck Femur-A Case Report.

INTRODUCTION: Traumatic dislocation of the hip with ipsilateral fracture neck femur is a rare injury because of the different mechanism of both these injuries. The management of such injuries is a challenge as the chances of nonunion and avascular necrosis of femoral head are very high with fixation methods. We report a case of obturator dislocation of the hip with ipsilateral fracture neck of the femur which was treated with uncemented total hip replacement.

CASE REPORT: A 32-year-old male sustained obturator dislocation with ipsilateral fracture neck femur following road traffic accident. After initial assessment and treatment, definitive treatment was carried out. Hip was approached through Watson-Jones approach. The head and neck was found to be dislocated and lying close to obturator foramen. A button hole through the anterior capsule and medium-sized chondral defect of the femoral head articular surface was noted. An uncemented total hip arthroplasty was performed. Post-operative period was uneventful and the patient was mobilized weight-bearing as tolerated with walker. He was discharged on the 5th post-operative day. He regained pain-free good range of motion over a period of 6 weeks.

CONCLUSION: Fracture pattern combining obturator dislocation and ipsilateral fracture neck femur is a rare injury. Although both head preservation and replacement methods of treatment are available, the choice of treatment depends on duration of injury, age of the patient, associated chondral injuries of femoral head, and the patient's choice. The antero-lateral or lateral approach helps to deal with the anteriorly lying head in a better way as compared to the postero-lateral approach.