Vascular complications in floating hip

The so-called floating hip involves a pelvis or an acetabular fracture together with an ipsilateral femur bone fracture. Concurrent injuries are also common in these cases, with the evolution and outcome worse than expected when these fractures exist in isolation. We studied a series of 11 patients with floating hip lesions. They all presented within a general polytrauma diagnosis. Diaphyseal femur fracture together with ipsilateral acetabular fracture was the most common combination. Supracondylar fracture occurred in 3 cases; these patients also had a popliteal vascular injury, and underwent a subsequent vascular repair. Although that treatment was promptly performed by a vascular surgeon, all of these patients in the end underwent an above-knee amputation. Bladder lesion, sciatic nerve injury, myositis ossificans, and skin injuries were also associated with these patients with a floating hip. Although vascular injuries in a floating hip have not been previously described in the literature, in our series these constituted the most severe complication. Whenever a major lower limb vascular injury coexists with a floating hip, prompt vascular repair must be accomplished. However, according to our experience, the nature of these lesions makes any expectation of limb viability very unlikely.