Posterior Hip DislocationWith Femoral Head Fracture:An Unusual Injury

摘要

A 61-year-old forester was pinned when a tree he was cutting fell across his hips. His workmates were able to extricate him and, through their heroic efforts, he was evacuated from the site. On arrival at our trauma center, he was alert, oriented, and complaining of severe right hip pain. His vital signs all were within normal limits. On physical examination, his lungs were clear to auscultation throughout, his abdomen was soft, non-tender, and without bruising. His right leg was ad-ducted, internally rotated, and shortened (Figure 1). He had exquisite tenderness to palpation above the right hip and a slight amount of crepitus. His right knee had scars from previous knee surgeries, but was non-tender to palpation and had no effusion. Distally, he had 5/5 strength in his ankle dorsiflexors, plantar flexors, evertors, and invertors. His sensation was intact to light touch and his dorsalis pedis pulse was 2+ on palpation. He had no scrotal hematoma and no blood at his urinary meatus. Findings from the rest of his physical examination, including evaluation of his left lower extremity, were unremarkable.