Hip Pelvis.  2014 Sep;26(3):185-188. 10.5371/hp.2014.26.3.185.

Osteonecrosis of the Femoral Head in the Setting of a Complex Acetabulum Fracture without Hip Dislocation Treated Surgically Using Ilio-inguinal Approach: A Case Report

• Sobti AS
• Oh KJ

• KMID: 2054183
• DOI: http://doi.org/10.5371/hp.2014.26.3.185

Abstract

Osteonecrosis in isolated fractures of the acetabulum without dislocation of hip seems to be a known complication, but to our knowledge it has not been reported adequately. The causative nature of post-traumatic femoral head osteonecrosis has not been studied critically. The pathophysiology of osteonecrosis in this case also eludes us. Striking evidence points towards the intra-operative blood loss and low mean arterial pressure possibly leading to hypo-perfusion of femoral head leading to osteonecrosis. Fractures of the acetabulum pose a difficult problem for the patient and the surgeon because of possible complications. Thus any surgeon involved in surgery for fractures of the acetabulum should be aware of the possibility of this potential complication. Here is a 61-year male, who sustained a complex fracture of the acetabulum without hip dislocation, subsequently was treated surgically with internal fixation using an anterior approach, 10 months after surgery patient developed osteonecrosis of the femoral head.

Keyword

Acetabular fracture; Osteonecrosis of the femoral head; Acetabulum fracture complication

MeSH Terms

Acetabulum*
Arterial Pressure
Dislocations
Head*
Hip
Hip Dislocation*
Humans
Male
Osteonecrosis*
Strikes, Employee

Figure

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  Fig. 1 Preoperative images. (A) X-ray image. (B) Computed tomography scan.

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  Fig. 2 Postoperative images. (A) X-ray image of immediately after surgery. (B) X-ray image after 10 months.

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  Fig. 3 (A) Computed tomography scan showing osteonecrosis of the femoral head. (B) Postoperative x-ray image after total hip replacement.

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