Management and Outcomes of Anterior Hip Dislocation with Multiple Comminuted Fractures from a Vehicular Crush Injury in a 44-Year-Old Woman.

Abstract

BACKGROUND Anterior hip dislocation is a rare injury that often occurs following high-energy road traffic accidents and accounts for approximately 7% to 13% of all hip dislocations. This report describes the presentation, diagnosis, and treatment of a 44-year-old woman with anterior hip dislocation and multiple comminuted fractures due to a vehicular crush injury. A PubMed search showed no similar cases have been reported in the English literature. CASE REPORT A 44-year-old woman was urgently seen at a local hospital after being run over twice by the rear wheel of a reversing truck while walking. Radiographic examination revealed right obturator-type anterior hip dislocation and multiple injuries. Pelvic external fixation and right femoral supracondylar bone traction were performed. Subsequent to hemodynamic stabilization, the patient was transferred to our hospital. Five days later, open reduction internal fixation was performed. Anterior pelvic ring internal fixation was performed after 20 days. The patient was hospitalized for 33 days. At the 5-year postoperative follow-up, the CT image showed healing. There was no lumbar or hip pain, and the patient had returned to normal life and work. CONCLUSIONS Anterior hip dislocation combined with bilateral obturator fractures, sacral fractures, lumbar fractures, and thoraco-abdominal injuries are rare in clinical practice. It is crucial to correctly handle multiple injuries to achieve enhanced recovery after surgery and prevent complications. The aim of this study is to document the clinical presentation, management, and outcomes of this unique case, highlighting the challenges and potential complications associated with femoral head displacement toward the obturator foramen.