Delbet type Ib trans-epiphyseal separation of femoral neck with posterior acetabular fracture in an adolescent male: A case-based review

Abstract

Background: In developing countries, patients usually present to the hospital several days after trauma, and many receive alternate therapies before. Management of unreduced dislocation of the hip becomes more challenging as time progresses. Traumatic hip dislocation with trans-epiphyseal fracture of the head of the femur (Delbet TYPE Ib) is a rare association with a high complication rate. Delayed presentation, failure of closed reduction, or instability of the hip joint are indications to perform open reduction and internal fixation. Case report: We report a 14-year-old boy who presented nearly a week after sustaining a trans-epiphyseal separation of the left femoral head with a dislocation and posterior acetabular wall fracture. He was treated with open reduction and internal fixation of the femoral head and the posterior acetabular wall. At a two-year follow-up, the boy had a satisfactory outcome and no signs of avascular necrosis. Conclusion: A detailed literature search showed that similar injury has been reported only five times in the past and good outcomes can be expected if careful early surgical intervention is planned irrespective of the duration since injury and the number of closed reductions attempted.

Keywords

• Femoral neck fracture
• Hip dislocation
• Acetabulum fracture
• Avascular necrosis of femur head
• Open reduction