Iatrogenic Obturator Hip Dislocation with Intrapelvic Migration.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Arthroplasty

Background:

• Obturator hip dislocations are rare, typically resulting from high-energy trauma in native hips and treated with closed reduction.
• Foraminal obturator hip dislocations, penetrating the obturator foramen, are exceedingly rare, with only three prior reports in native hips.
• No cases of foraminal obturator dislocations following total hip arthroplasty (THA) have been previously documented.

Observation:

• A patient with a chronic greater trochanter fracture experienced a posterior hip dislocation after THA.
• During attempted closed reduction, an iatrogenic periprosthetic foraminal obturator hip dislocation occurred.
• The patient's altered joint biomechanics and weakened hip abductor mechanism contributed to this rare dislocation subtype.

Findings:

• This is the first reported case of a periprosthetic foraminal obturator hip dislocation.
• The dislocation was successfully treated with open surgical intervention.
• Early identification prevented further closed reduction attempts, avoiding potential damage to intrapelvic structures.

Implications:

• This case highlights a rare but potential complication after total hip arthroplasty.
• Awareness of this specific dislocation subtype is crucial for orthopedic surgeons.
• Prompt diagnosis and appropriate management are essential to prevent severe complications.