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Complex Reconstruction of Post-traumatic Fracture Dislocation Hip: The Anchor Total Hip Arthroplasty Following Failed
Vijay G Goni1, Deepak Kumar1, P K Vivek1
1Department of Orthopaedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Introduction:
Acetabular fracture-dislocations are complex injuries that, if misdiagnosed or mismanaged, can lead to avascular necrosis and early total hip arthroplasty (THA) failure.
Case Report:
A 16-year-old male with a neglected acetabular fracture-dislocation underwent an ill-planned THA, with the cup placed in fracture callus, which was removed the next day. He later presented in a Girdlestone-like state. Imaging and 3D modeling revealed a malunited posterior wall and column fracture. A staged approach - corrective osteotomy with fixation followed by revision THA - was performed.
Result:
At 10 months, he achieved excellent function and stable radiographic reconstruction.
Conclusion:
Early recognition, detailed pre-operative planning, and 3D-assisted individualized surgical strategies are vital for successful reconstruction of neglected or failed acetabular fracture-dislocations.