Reconstruction of Left Hip Joint

We are quite Proud to share a complicated case with a fractured hip that survived through a simple and reproducible fixation technique by Dr. Prateek Goyal, Senior Consultant and Orthopedic Surgeon @ SDMH, Jaipur

35 years old male, A banker in AU bank sustained road traffic accident and there were Severe injury to his left hip joint, face, chest along with head injury. He stayed in ICU for 15 days due to Polytrauma. On radiological ( Xray and CT) evaluation he was diagnosed to have communicated fracture of the neck of the left femur with fracture of superolateral part of the neck as well as avulsion or trochanter of the left hip. Hardly any neck was left for fixation.

After 15 days of the traumatic event and Considering his young age it was planned to reconstruct his left hip joint. we explained the prognosis to the patient and when he agreed we moved further with the plan of reconstruction.

We close reduced and maintained the fracture fragments in Alignment under CCTV. Normal head neck and shaft angle of the femur achieved and we fixed the main head and neck segment with the help of a simple DHS implant.

The superior end superolateral part of the neck was also avulsed and fractured .we planned not to touch it or open reduce the hip joint and avoid further damage to vascularity rather, we decided to reconstruct it with the help of fibula. we took ipsilateral fibula and reconstructed the deficient superior cortex of the neck by guiding over a previously placed guidewire (all closed).

After 4-5 months of follow up now, we allowed full wt bearing with a stick, the patient has an almost full range of motion without pain and is able to manage his daily living.