Hip Pelvis.  2014 Dec;26(4):275-278. 10.5371/hp.2014.26.4.275.

Fracture of the Greater Trochanter during Closed Reduction of Obturator Type Hip Dislocation

• Yang JH
• Pandher DS
• Oh KJ

• KMID: 1907705
• DOI: http://doi.org/10.5371/hp.2014.26.4.275

Abstract

Obturator (Inferior) type dislocation of the hip joint is a rare and the fracture of greater trochanter during closed reduction for it has never been reported in literature. In this report, we present a case of a fracture of greater trochanter during difficult closed reduction which required operative fixation. Surgeons need to be aware of this complication and excessive force for reduction should be avoided when treating of this type dislocation.

Keyword

Greater trochanter; Avulsion fracture; Obturator (Inferior) type hip dislocation; Closed reduction

MeSH Terms

Dislocations
Femur*
Hip Dislocation*
Hip Joint

Figure

• 

  Fig. 1 (A) Anteroposterior X-ray shows obturator type dislocation of the right hip. (B) Initial axial section computed tomography (CT) scan shows intact greater trochanter and acetabulum on right side. (C, D) Three-dimensional reconstruction CT shows no damage to the greater trochanter of the right hip.

• 

  Fig. 2 Post-reduction X-ray and computed tomography (CT) shows fracture of the greater trochanter. (A) Simple X-ray showing the minimal contour change (arrow) of the greater trochanter. (B) Pelvic axial CT clearly demonstrating the fracture of the greater trochanter (arrow). The fracture gap is more than 2 mm. (C) Three-dimensional reconstruction CT shows displaced fracture of the greater trochanter (arrow).

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  Fig. 3 (A) Open reduction and internal fixation with cannulated screws and washers was performed for fracture of right greater trochanter. (B) Follow-up X-ray at two years shows complete healing of the fracture.

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  Fig. 4 Illustration showing the possible cause of mechanism of injury. (A) Superior view showing the amount of abduction and external rotation for greater trochanter to impact against the ischium. (B) Same position of femur from oblique view. This view also demonstrates the flexion amount of hip. Notice the area of possible impact (black arrow).

Reference

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