[High-energy trauma with complex acetabular fracture and incarcerated fragment]

Acetabular fractures with displaced fragments represent a complex intraoperative challenge. This case report describes the successful treatment of an acetabular fracture with native hip dislocation in a 56-year-old man following high-energy trauma. Open reduction and internal fixation using the Kocher-Langenbeck approach was initially unsuccessful due to a posterior wall fragment, necessitating a trochanteric flip osteotomy. The patient developed an avascular necrosis of the femoral head, which is a frequent complication of acetabular fractures associated with hip dislocation. This emphasizes the importance of regular control follow-up. Despite the high-energy mechanism of injury, the patient showed excellent results based on the Harris hip score (HHS).