Hip Obturator Dislocation With Ipsilateral Femoral Neck Fracture:A Case Report And Literature Review

Objective: To report the detailed diagnosis,treatment and follow-up results of a case of closed dislocation of hip joint with ipsilateral femoral neck fracture.In view of this rare injury,a new internal fixation method was introduced,and the relevant literature was analyzed retrospectively.Methods: In June 2018,a case of hip joint closed dislocation combined with ipsilateral femoral neck fracture was treated in our department.After analyzing the fracture characteristics of the patient,combining with the age and physical quality of the patient,and improving the preoperative examination without obvious surgical contraindications,the scheme of hollow nail combined with medial femoral neck support plate was used for the first time for internal fixation.Through Wanfang database,CNKI,PubMed,web of science SCI and other databases,the case reports of hip joint closed hole dislocation combined with femoral neck fracture were searched.The Chinese search words were "Dislocation" and "femoral neck fracture",the English search words were "Dislocation" and "femoral neck fracture",the unqualified literature was excluded and the cases were collected.Combined with a case reported in this paper and related literature,the etiology,mechanism,treatment and complications of the injury were analyzed.Results: After 18 months follow-up,the fracture was completely healed,and no postoperative complications such as fracture displacement,heterotopic ossification,internal plant loosening,femoral neck varus and necrosis of femoral head were found.At present,the function of hip joint of patients is good,and they have returned to normal life.After searching the related literature and adding one case reported in this paper,13 cases of hip joint closed hole dislocation with ipsilateral femoral neck fracture were included.The average age of the patients was 38.23 ± 13.93.There were 10 male patients and 3 female patients.Among the 13 patients,9 were injured due to vehicle collision,3 were injured by heavy falling,and 1 was injured by high falling.All the patients received surgical treatment,including 6 cases of joint replacement,4 cases of total hip replacement,only 2 cases of femoral head replacement;7 cases of internal fixation,including 4 cases of hollow compression screw,2 cases of dynamic hip screw,1 case of hollow screw combined with medial support plate.In terms of postoperative complications,two patient lost the follow-up,6 of the remaining 11 patients had postoperative complications,accounting for 54.5%;in the internal fixation group,4 patients had postoperative complications,accounting for 57.1%.Of the 4 patients who were followed up,2 had complications,accounting for 50%.Conclusion: The injury of hip obturator dislocation with ipsilateral femoral neck fracture is rare.There are few reports at home and abroad,and there is no complete and effective epidemiological statistics.However,it is concluded that the injury is mainly caused by high-energy injury.The treatment of closed dislocation of hip joint combined with ipsilateral femoral neck fracture mainly depends on surgical treatment.For the first time,we used hollow nail combined with medial femoral neck support plate and single cortex fixation to treat hip joint closed dislocation with ipsilateral femoral neck fracture,and achieved satisfactory results.This innovative treatment scheme is feasible.