Arthroscopic-Assisted Removal of Incarcerated Fragment following Manual Reduction of Posterior Hip Dislocation in Acute Polytrauma Patient: A Case Report

急性多发伤患者手法复位后髋关节脱位后,关节镜辅助取出嵌顿骨碎片:病例报告

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Abstract

INTRODUCTION: Posterior hip dislocations combined with acetabular posterior wall fractures are usually managed with open reduction and internal fixation. However, select cases may benefit from closed reduction followed by minimally invasive arthroscopic evaluation. CASE REPORT: We report a case of a 27-year-old male who sustained left side complex posterior hip dislocation with ipsilateral compound Grade 2 fracture of the shaft of the tibia with facial and chest injury following a high-speed motorcycle accident. The injury was successfully managed with closed manual reduction of the hip joint with debridement and closed reduction internal fixation of the fractured tibia with intramedullary nailing and subsequent hip arthroscopy. Arthroscopy confirmed fracture stability, revealed loose bodies, and allowed chondral assessment without the need for open reduction. At 3 months follow-up, the patient had returned to full activity with no signs of instability of the hip joint or arthritis, supporting the use of arthroscopy in select cases. CONCLUSION: Hip arthroscopy following successful closed reduction is a valuable minimally invasive option in selected posterior hip dislocations, enabling removal of incarcerated fragments, confirmation of stability, reduced surgical morbidity, and favorable functional outcomes.

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