Challenges in treating combined posterior hip dislocation and ipsilateral intertrochanteric fracture: a case report.

Abstract

The concomitant occurrence of posterior hip dislocation with an ipsilateral intertrochanteric fracture is an exceptionally rare and complex orthopedic injury that poses significant diagnostic and therapeutic challenges. This report presents two cases of this unusual injury pattern, each resulting from high-energy motor vehicle accidents. Patients presented with acute pain and functional impairment of the affected lower limb. Radiographic evaluation confirmed posterior dislocation of the hip associated with an ipsilateral intertrochanteric fracture. Prompt open reduction was necessitated to prevent iatrogenic complications and minimize the risk of avascular necrosis of the femoral head. Definitive fixation of the intertrochanteric fracture was achieved using a Dynamic Hip Screw (DHS) or Dynamic Condylar Screw (DCS), selected based on fracture morphology. Postoperative management focused on staged rehabilitation to optimize recovery. Both patients achieved satisfactory functional outcomes, with Harris Hip Scores of 78 and 82 at one-year follow-up, respectively. The aim of this case report is to present and analyze two rare cases of combined posterior hip dislocation with ipsilateral intertrochanteric fracture, highlighting the diagnostic complexities, surgical challenges and considerations for achieving favorable functional outcomes in the absence of standardized treatment protocols.