Abstract
This is the report about the surgical treatment for patient operated 5 month after injury with the neglected dislocation fracture of the hip joint. The patient is 39-year male. After being carried to another hospital by an ambulance because of the motorbike accident, he had a operative treatment for the fracture of the right lower leg and open fracture of the left ankle joint.
After dischage the hospital, he was permitted to bear partial weight on crutches. He had x-ray check the hip joint after 4 month operation, because he felt pain in right hip joint. Then the dislocation fracture of the right hip joint become clear and the patient was introduced to our hospital. The results of x-ray and CT, femoral head had dislocated posterosuperior severely with fracture of the femoral head (Pipkin type 1) and acetabular fracture. The femoral head had traumatic change and partial necrosis by MRI. The patient was preoperativeiy treated with femoral pin traction. As for the treatment, we performed open reduction used a plate, a screw and fixed the acetabular bone and performed build-up by a transplantation bone for large acetabular bone defect. At one year postoperatively, union has occurred and the expansion of the hemoral head necrosis was not found. Poperative two years, he works as a bus driver and doesn't have pain during walking. JOA score is 82 points and no joint transformation was found in X-ray diagnosis. It is often appointed in the surgical treatment for the neglected dislocation fracture of the hip joint that complications of high ratio of necrosis and cartilage disorder happen and arthrosis proceeds soon after the surgery. In this case, surgical treatment was selected because of patient's age, health condition and requests into consideration. among the selections such as articular head resection, arthrodesis and total hip arthroplasty. So far, the short term results are regarded good after surgery, but want to perform follow up carefully.
