Intertrochanteric fracture of the femur with ipsilateral central fracture of the acetabulum

Browne, R; Mullan, G.B.

doi:10.1016/s0020-1383(80)80053-2

Cited by 17 publications

(13 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[7][8][9][10] There are isolated reports of central acetabular fracture in combination with ipsilateral femoral neck fracture 2-4 and intertrochanteric fracture. 1 Central acetabular fracture with dislocation of bilateral femoral heads into the pelvis has been reported with sustained myoclonus during seizure. [11][12][13][14] To the best of our knowledge, this is the first reported instance of incarcerated central dislocation of a fractured proximal femur.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] These combined injuries can be quite difficult to treat. 1,2,5 We present a patient with an unusual fracture in which the proximal femur was fractured and irreducibly dislocated through a central acetabular fracture into the pelvis. This case contains several important learning experiences regarding timing and preoperative planning in complex injury patterns.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Case Report: Associated Both-Column Acetabulum Fracture With an Ipsilateral Centrally Dislocated Intertrochanteric Femur Fracture

Barrett

Anglen²,

Hoernschemeyer³

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

View full text Add to dashboard Cite

he simultaneous occurrence of an acetabulum fracture with an ipsilateral centrally dislocated proximal femur fracture is a rare injury. 1-4 These combined injuries can be quite difficult to treat. 1,2,5 We present a patient with an unusual fracture in which the proximal femur was fractured and irreducibly dislocated through a central acetabular fracture into the pelvis. This case contains several important learning experiences regarding timing and preoperative planning in complex injury patterns. CASE REPORTA 31-year-old man was involved in a motorcycle crash in which he struck a utility pole. The patient had respiratory compromise at the scene. When attempts at intubation failed, cricothyroidotomy was performed in the field. Physical examination upon presentation to our trauma center showed his left leg to be shortened and malrotated. The overlying skin was intact. Radiographic examination (Fig. 1) revealed a complex left acetabulum fracture, later classified as a bothcolumn injury, as well as a proximal femur fracture with intrapelvic displacement of the femoral head, neck, and lesser trochanter. Admitting Glasgow Coma Scale score measured 3T (intubated), and computed tomography (CT) examination of the patient's head revealed a significant intraparenchymal hemorrhage. Additional scans were not completed because of the patient's airway instability. He was emergently taken to the operating room by the surgery trauma service for a tracheostomy to secure the airway. The orthopedic on-call team simultaneously attempted management of his complex acetabular fracture-dislocation, with the intention of reducing the proximal femur from the pelvis to the acetabulum and deferring further treatment to the orthopedic traumatologist.The patient was placed supine on a fracture table in boot traction. A lateral approach to the proximal femur was performed. The dissection was continued down to the level of the proximal femur fragment. Multiple attempts were made to extract the dislocated femoral head from the pelvis through the central acetabular defect. Retractors, bone clamps, and traction through the lag screw of a sliding hip-screw system were all used unsuccessfully. The lateral window of the ilioinguinal approach was then performed. Dissection was carried down along the internal iliac fossa, elevating the iliacus, with the intention of freeing and pushing the femoral head out from within the pelvis. The surface of the femoral head was visualized, and the articular cartilage was intact. Unfortunately, the margins of the acetabular fracture remained immobile, and the femoral head was irreducible.Because of prolonged operative time (4 hours) and excessive ongoing blood loss of 1, 200 mL in a patient with significant closed head trauma, the decision was made to leave the hip dislocated. The wounds were closed, and the patient was returned to the intensive care unit for further resuscitation and rewarming. The next morning, the orthopedic service traumatologist assumed care of the patient's musculoskeletal injuries. During this...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Case Report: Associated Both-Column Acetabulum Fracture With an Ipsilateral Centrally Dislocated Intertrochanteric Femur Fracture

Barrett

Anglen²,

Hoernschemeyer³

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

View full text Add to dashboard Cite

show abstract

“…Before 1990, there were only a few case reports on floating hip injury (2,3). Liebergall and coworkers (4) first reported a series of 17 patients from two major trauma centres.…”

Section: Discussionmentioning

confidence: 99%

Concomitant ipsilateral floating hip and floating knee injuries: a unique injury and review of the literature*

Soong

Maguire

et al. 2007

International Journal of Clinical Practice

View full text Add to dashboard Cite

“…Because they result from high-impact, intra-articular injuries, acetabular fractures with ipsilateral intertrochanteric fractures always present innate di culties for surgeons in terms of their management [9,11,18,23]. In this study, all patients received surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, fractures involving both the acetabulum and femoral trochanter are rarely reported. To date, only a few cases of acetabular fracture combined with ipsilateral intertrochanteric fracture have been reported [9][10][11]. In these reports, the etiology, management and prognosis of patients with acetabular fracture combined with ipsilateral intertrochanteric fracture were described.…”

Section: Introductionmentioning

confidence: 99%

Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.

show abstract

Intertrochanteric fracture of the femur with ipsilateral central fracture of the acetabulum

Cited by 17 publications

References 2 publications

Case Report: Associated Both-Column Acetabulum Fracture With an Ipsilateral Centrally Dislocated Intertrochanteric Femur Fracture

Case Report: Associated Both-Column Acetabulum Fracture With an Ipsilateral Centrally Dislocated Intertrochanteric Femur Fracture

Concomitant ipsilateral floating hip and floating knee injuries: a unique injury and review of the literature*

Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

Contact Info

Product

Resources

About