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Deep wound infection after a trochanteric fracture internal fixation presenting with hip dislocation: a case report

Tzurbakis M, Morakis E, Mouzopoulos G, Lasanianos N, Georgilas I - Cases J (2010)

Bottom Line: The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done.In three years follow-up the patients presented with a fully functional hip without any signs of infection.Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality.

Affiliation: 1st Orthopaedic Department of 'Evaggelismos' General Hospital, Athens, Greece. manolismorakis@hotmail.com.

ABSTRACT

We report a rare case of posterior hip dislocation after a low energy trauma. The patient sustained a trochanteric fracture in the same hip six months ago, which was fixed using a sliding hip screw and had healed. At surgery a deep wound infection was found and a methicillin-resistant Staphylococcus epidermidis (MRSE) was cultured. After thorough debridement, an excisional arthroplasty was decided. The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done. In three years follow-up the patients presented with a fully functional hip without any signs of infection. Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality. Infection eradication and a second stage arthroplasty can be life and limb saving.

X-ray of the left hip demonstrating a posterior hip dislocation.
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Figure 1: X-ray of the left hip demonstrating a posterior hip dislocation.

Mentions: A 78-year-old female presented in the emergency department limping following a low-energy fall 24 hours ago. Her left limb was painful, shortened and internally rotated without any vascular or neurological compromise. She presented without fever, wound drainage, abscess formation or cellulitis. X-ray imaging performed revealed a left hip posterior dislocation (Fig 1 &2). Computer tomography imaging confirmed the diagnosis and didn't reveal an abscess formation (Fig. 3 &4). The patient sustained a left trochanteric fracture six months ago which was fixed using a sliding hip screw. Her postoperative period was without any complications and the fracture has united.

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Deep wound infection after a trochanteric fracture internal fixation presenting with hip dislocation: a case report

Tzurbakis M, Morakis E, Mouzopoulos G, Lasanianos N, Georgilas I - Cases J (2010)

X-ray of the left hip demonstrating a posterior hip dislocation.
© Copyright Policy
Figure 1: X-ray of the left hip demonstrating a posterior hip dislocation.
Mentions: A 78-year-old female presented in the emergency department limping following a low-energy fall 24 hours ago. Her left limb was painful, shortened and internally rotated without any vascular or neurological compromise. She presented without fever, wound drainage, abscess formation or cellulitis. X-ray imaging performed revealed a left hip posterior dislocation (Fig 1 &2). Computer tomography imaging confirmed the diagnosis and didn't reveal an abscess formation (Fig. 3 &4). The patient sustained a left trochanteric fracture six months ago which was fixed using a sliding hip screw. Her postoperative period was without any complications and the fracture has united.

Bottom Line: The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done.In three years follow-up the patients presented with a fully functional hip without any signs of infection.Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality.

Affiliation: 1st Orthopaedic Department of 'Evaggelismos' General Hospital, Athens, Greece. manolismorakis@hotmail.com.

ABSTRACT

Background: We report a rare case of posterior hip dislocation after a low energy trauma. The patient sustained a trochanteric fracture in the same hip six months ago, which was fixed using a sliding hip screw and had healed. At surgery a deep wound infection was found and a methicillin-resistant Staphylococcus epidermidis (MRSE) was cultured. After thorough debridement, an excisional arthroplasty was decided. The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done. In three years follow-up the patients presented with a fully functional hip without any signs of infection. Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality. Infection eradication and a second stage arthroplasty can be life and limb saving.

View Similar Images In: Results  - Collection
View Article: Pubmed Central - HTML -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=2829518&rFormat=json&query=null&req=5