Challenges and solutions in the fixation of a hip fracture in the presence of a contralateral ankylosed hip: a case report. Issue 5 (September 2014)

• Record Type: Journal Article
• Authors: Davidson, Donald J.; Muoneke, Hyginus; Huber, Chris P.
• Is Part Of: Hip international. Volume 24:Issue 5(2014)
• Page Start: 485
• Page End: 490
• Publication Date: 2014-09
• Subjects: Intracapsular fracture femur -- Ankylosed hip -- Patient positioning -- Osteogenesis imperfecta; Hip joint -- Pathophysiology -- Periodicals; Hip joint -- Diseases -- Periodicals; Hip joint -- Surgery -- Periodicals; 617.581005
• DOI: 10.5301/hipint.5000147
• Languages: English
• ISSNs: 1120-7000

Abstract

Background: An intracapsular femoral neck fracture is a common orthopaedic presentation and requires expedient fixation in a young adult. This case demonstrates how patient-specific factors, namely an ankylosed contralateral hip, can make a common operation challenging. Case Description: A 22-year-old man with osteogenesis imperfecta and multiple bony deformities was brought to A&E after being involved in a motor vehicle collision. Plain radiographs and clinical examination demonstrated a right intracapsular femoral neck fracture, ipsilateral femora vara and a contralateral ankylosed hip secondary to protrusio acetabuli. The intraoperative patient and fluoroscopic positioning were technically challenging. Clinical Relevance: Preoperative literature review revealed no operative strategy or case report describing how best to perform closed reduction and internal fixation of a femoral neck fracture with a co-existing contralateral ankylosed hip joint. We hope our experience will aid other surgeons who find themselves in a similar clinical scenario. We will present the difficulties faced and the adaptations made to our surgical technique which we utilised to achieve an anatomical fixation.