Obturator dislocation of the femoral head combined with ipsilateral femoral neck and pubic fractures: A rare case report

RATIONALE: Obturator dislocation of the femoral head combined with ipsilateral femoral neck and pubic fracture is a rare injury. We used cannulated screws combined with a femoral neck medial plate for the first time to treat this type of injury and achieved good follow-up results. PATIENT CONCERNS: The patient was hospitalized due to an accident resulting in swelling and deformity accompanied by limited mobility of the right hip and left knee. DIAGNOSES: X-ray examination and computed tomography confirmed that the patient suffered from right hip obturator dislocation, femoral head and neck fracture, pubic fracture, as well as open fracture of the left femoral shaft. INTERVENTIONS: Open reduction and internal fixation with cannulated screws and a medial support plate of the femoral neck were performed for the right hip obturator dislocation, femoral head and neck fracture, and the pubic fracture. Artificial bone grafting was performed to support the femoral head defect. Debridement and the second phase of internal fixation were executed to cure the open fracture of the left femoral shaft. OUTCOMES: The patient was followed-up for 6 months and showed good hip function. X-ray examination and computed tomography indicated that the fractures healed well without fracture displacement or loosening of the implants. Meanwhile, there were no signs of femoral neck valgus and femoral head necrosis observed. LESSONS: The combination of cannulated screws and medial support plate was suggested for the treatment of hip obturator dislocation and femoral head and neck fracture. Furthermore, partial weight loading exercise should be performed promptly to reduce the risk of muscular atrophy and myasthenia.