Floating hip injury managed in a single stage with good outcome
Keywords:
floating hip, single stage, classification, order of fixation of fracture.Abstract
Introduction: The term floating hip is used to denote a fracture pattern involving fracture of pelvis or acetabulum and ipsilateral femur. These injuries are seen as a result of high velocity trauma.
Objective: Our objective was to highlight the usefulness of single stage surgery using a common incision, the order of fracture fixation, in lateral decubitus position for type B floating hip injuries.
Case report: A 58-year-old male, was brought presented to our emergency department with pain, swelling, deformity of right lower limb following a road traffic accident. On primary examination, patient was in hypovolemic shock. Imaging revealed the right posterior column and posterior wall of acetabulum with ipsilateral diaphyseal femur fracture. After stabilizing the patient, we operated on him in a single stage in lateral decubitus position, in which we fixed the femur first followed by acetabulum.
Conclusion: Single stage fixation in lateral decubitus position after adequate resuscitation and evaluation can offer a good outcome by reducing the operative time and post- operative complications.
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References
Liebergall M, Mosheiff R, Safran O, Peyser A, Segal D. The floating hip injury: patterns of injury. Injury. 2002;33(8):717-22. DOI: https://doi.org/10.1016/s0020-1383(01)00204-2
Muller EJ, Siebenrock K, Ekkernkamp A, Ganz R, Muhr G. Ipsilateral fractures of the pelvis and the femur--floating hip? Arch Orthop Trauma Surg. 1999;119(3-4):179-82. DOI: https://doi.org/10.1007/s004020050385
Zamora P, Estades FJ, Cano JR, Guerado E. Floating hip and associated injuries. Injury. 2017;48 suppl 6:s75-80. DOI: https://doi.org/10.1016/S0020-1383(17)30798-2
Sen R, Jha L. Floating Hip. J Clin Orthop. 2017 [acceso 21/03/2021];2(1):43-8. Available at: http://jcorth.com/2017/06/10/floating-hip/
Rajasekaran RB, Jayaramaraju D, Palanisami DR, Perumal R, Shanmuganathan R. Ipsilateral acetabular fracture with displaced femoral head and femoral shaft fracture: a complex floating hip injury. Case Rep Orthop. 2018;2018:4937472. DOI: https://doi.org/10.1155/2018/4937472
Cannada LK, Hire JM, Boyer PJ, Israel H, Mir H, Halvorson J, et al. Treatment and complications of patients with ipsilateral acetabular and femur fractures: A multicenter retrospective analysis. J Orthop Trauma. 2017;31(12):650-6. DOI: https://doi.org/10.1097/bot.0000000000000966
Helal B, Skevis X. Unrecognised dislocation of the hip in fractures of the femoral shaft. J Bone Joint Surg Br. 1967 [acceso 21/03/2021];49(2):293-300. Available at: https://pubmed.ncbi.nlm.nih.gov/6026515/
Han I, Min G. Floating hip: A case report. J Orthop Trauma Surg Rel Res. 2017 [acceso 21/03/2021];12:8-10. Available at: https://www.jotsrr.org/articles/floating-hip-a-case-report-3133.html
Tiedeken NC, Saldanha V, Handal J, Raphael J. The irreducible floating hip: a unique presentation of a rare injury. J Surg Case Rep. 2013;2013(10):rjt075. DOI: https://doi.org/10.1093/jscr/rjt075
Kregor PJ, Templeman D. Associated injuries complicating the management of acetabular fractures: review and case studies. Orthop Clin North Am. 2002;33(1):73-95. DOI: https://doi.org/10.1016/s0030-5898(03)00073-7
Suzuki T, Shindo M, Soma K. The floating hip injury: which should we fix first? Eur J Orthop Surg Traumatol. 2006;16(3):214-8. DOI: https://doi.org/10.1007/s00590-006-0081-4
Siavashi B. Floating Hip, eleven cases and literature review. J Orthop Spin Trauma. 2017;3(1). DOI: https://doi.org/10.5812/jost.63868
Meena UK, Bansal MC, Behera P, Goyal D, Kumar R. Concomitant ipsilateral acetabular and femoral fractures - an appraisal of outcomes and complications in 34 patients. Acta Orthop Belg. 2021 [acceso 21/03/2021];87(3):401-10. Available at: http://www.actaorthopaedica.be/assets/3149/03-Behera.pdf
Benabbouha A, Boussouga M, Fjouji S, Lamkhanter A, Jaafar A. Simultaneous ipsilateral floating hip and knee: a complex combination and difficult surgical challenge. Case Rep Orthop. 2020;2020:9197872. DOI: https://doi.org/10.1155/2020/9197872