Beyond conventional methods: The trans-trochanteric approach and the role of preoperative CT in optimal management of femoral head fracture-dislocation

Abstract

Hip fracture-dislocations are uncommon injuries that require substantial force and can be complicated by residual cartilaginous or bony fragments, making reduction challenging. Although immediate closed reduction is typically the initial treatment, open reduction becomes necessary when closed methods fail or in the presence of associated fractures or femoral head fractures. The long-term prognosis is influenced by the direction of dislocation and the severity of the injury, with young adults, particularly those in road traffic accidents, being at higher risk for complications such as osteoarthritis. We present a case of a 28-year-old patient who sustained a femoral head fracture-dislocation. The patient was treated with an open reduction using a trans-trochanteric approach, and the femoral head was stabilized with 2 screws. This case highlights the effective management of complex hip fracture-dislocations through open reduction with a trans-trochanteric approach, emphasizing the importance of timely intervention to address both dislocation and associated fractures.