A 78 year old Patient had an RTA and sustained a Hip injury. He was diagnosed as having a Central fracture dislocation (Bicolumnar Fracture). He was not operated by the treating Orthopedic Surgeon considering the Risks involved at the Age. He presented to us after 7 months with ProtrusioAcetabuli with AVN of Femoral head.
His major Complaints were:
- Severe restriction of daily activities
- Night pain and Rest Pain
- Difficulty in Sitting and Getting up
PLATE XRAY
Pre Op Xray
Discussing the risks involved, the Patient was asked to undergo a hip replacement to alleviate his symptoms.
CT Pelvis was done to get a better understanding of the defects.
CT findings
- S Defect in anterosuperior wall
- Posterior wall was intact
- Defect in anterosuperior part of head
Challenges of Surgery
- Defect Reconstitution
- To get the Perfect Rim fit
- Early mobilization considering the advanced age
- Restoring near normal Hip Centre
Operative Pearls
- It was decided to use a Trabecular Metal cup and Uncemented Stem on the Femoral side Head and neck
- The graft was Fixed with the Screws through the cup
- Rim fit Gription Cup was placed and sufficient lateralization was achieved
