The incidence of a femoral head fracture in conjunction with a hip dislocation is 16%. 3.Ganz trochanteric “flip” osteotomy. Femoral head fracture-dislocation is a joint trauma condition with a compromised medium and long-term functional prognosis. When there is a hip dislocation, the femoral head is pushed either backward out of the socket, or forward. Femoral head prosthesis dislocation. We used cannulated screws combined with a femoral neck medial plate for the first time to treat this type of injury and achieved good follow-up results. These … Two general categories of hip dislocations exist, anterior and posterior. Rationale: Obturator dislocation of the femoral head combined with ipsilateral femoral neck and pubic fracture is a rare injury. Anterior hip dislocations occur when the femoral head pushes forward out of the socket of the acetabulum. Posterior dislocation. 7 Indentation lesions of the femoral head occur in 25% to 75% of anterior dislocations. Schicho and Riepl reported a femoral head dislocation to the scrotum in a 33 year old man, recently (11). … For the surgeon on ED duty, these are a true challenge – since this is not a common trauma case, he or she may not have much experience in making this type of treatment decision. Previous Next: Sport-Specific Biomechanics. Common complications include the following: Sciatic nerve injury: The nerve runs behind the hip and can be stretched and damaged with a hip dislocation. In approximately 90% of hip dislocation patients, the thighbone is pushed out of the socket in a backwards direction. The femoral head, on the other hand, has an extremely tenuous blood supply from a small branch of the obturator artery that passes with the femoral ligament. Dislocation is one of the more common complications of hip joint replacement. This is called a posterior dislocation. Case contributed by Dr Jeremy Jones Diagnosis certain Diagnosis certain . Posterior dislocations compose 70-80% of all hip dislocations and 90% of all sports-related hip dislocations. Frontal Dislocation of femoral head prosthesis on the right. Another subtype of anterior dislocation less frequently used is the perineal type, which describes a dislocation where the femoral head is more inferior than in the standard obturator dislocation . When there is a hip dislocation, the femoral head is pushed either backward out of the socket, or forward. This is called a posterior dislocation. If the fragment is sufficiently large for reattachment and the extent of damage of the femoral head can be seen in the subluxed position, complete dislocation may not be necessary and this reduces morbidity.

Best option not known: Damage to blood supply from anterior capsulotomy vs. damage to blood supply from transecting ligamentum teres. From the case: Femoral head prosthesis dislocation. True shear-type fractures in the frontal plane of the femoral head occur in 10% of posterior dislocations.
Case Discussion. In approximately 90% of hip dislocation patients, the thighbone is pushed out of the socket in a backwards direction. Images in Clinical Medicine from The New England Journal of Medicine — Femoral-Head Dislocation to the Scrotum Posterior dislocations, where the femoral head moves backward, are most common and often occur from car wrecks and athletic injuries. As previously mentioned, a femoral head fracture may be a component of the injury pattern, and can be hard to recognize on plain imaging.

Chiron P(1), Lafontan V, Reina N. Author information: (1)Orthopaedics and Trauma Surgery, Rangueil University Hospital Centre, 1, avenue J.-Poulhès, Toulouse cedex 09, France. 7 Hip dislocations and femoral head fractures are usually associated with other injuries, either systemic or musculoskeletal. X-ray. wound, fix femoral head fracture from anterior approach (either now or later). Fracture-dislocations of the femoral head. This type of hip dislocation can occur in downhill skiing accidents. Posterior dislocation. If complete dislocation is necessary, obstetric scissors should be used to cut the ligamentum teres.