Title : Chronic obturator type anterior hip dislocation: Open reduction using Ganz trochanteric flip osteotomy- Case report
Abstract:
Chronic obturator type anterior hip dislocation is rarely seen particularly in developed countries and there are limited literatures available about the subject matter. At our hospital we have treated one patient having chronic obturator type anterior hip dislocation with Ganz trochanteric flip osteotomy. The patient a farmer in the rural part of the country presented with donkey accident of 7 months out. She has traditional bonesetter repeatedly for 6 months. After she presented to our hospital, she had X-ray and MRI which has no evidence for avascular necrosis but radiologist recommended Hip CT scan for the suspicion of femur head fracture and patient scanned. The CT scan shows impaction fracture at the antero superior area of the femur head. And then patient counselled and decided for open reduction. Currently come for left hip pain and difficulty of walking because of the deformity. Following surgery patient was kept non weight bearing for 6 weeks with bilateral axillary crutches. Patent counseled for hip precautions to prevent radiolocation. Currently the patient is weight bearing as tolerated with good functional outcome. So even though in chronic hip dislocation the risk of avascular necrosis of femur head if the MRI finding is not severe open reduction can be tried for those type of patients rather than other options like arthrodesis, girdle-stone and arthroplasty. Regarding the surgical approach Gibson’s approach (modified Kocher approach) to the hip give better exposure for supero-posteriorly situated acetabulum and making easy dissection antero-infero-medially placed femur head.
