Hip Central Luxation

Traumatic hip central dislocation in a 40 years old man.

Which teatment do you propose ?

Which approaches?

The question was posted on Linkedin, answers were:

1. Posterior approach and plate

2. Posterior and anterior approach: plating posterior and anterior

3. Iliofemoral approach: plating posterior and anterior column

4. Posterior approach and plating, Fix ext anterior

Your choice is influenced by the following factors:

1. achieve maximal stability and fast weigth bearing (but you have to consider full weigth bearing on the rigth site or full weigth bearing bilateral)

2. minimal approach morbidity (Fix ex is lesser invasive than anterior approach; posterior approach has head necrosis risk:but can you reduce the acetabulum transverse fracture from anterior? do you need anterior plating for healing ?)

The question you should answer for each for the proposed treatment options is: how long is the post OP recovery time, when is weigth bearing allowed according to you and are there significant differences between the treatment choices which can justify a more aggressive treatment?

We chose one of the proposed treatments. Click here to see it (you must login as doctor): this doesn't mean that we think our choice is the only correct one.