Anterior hip fracture-dislocation resembling a Hill-Sachs lesion: a case report and review of this special clinical entity.

PURPOSE

Anterior hip fracture-dislocation is a rare high energy injury with poor long-term prognosis. A Hill-Sachs-like hip fracture-dislocation is only scarcely described in the literature.

CASE

We report the case of a 57-year-old suffering an anterior hip fracture-dislocation after a self-inflicted collision with his motorcycle. Knee impaction on the ground with hip abduction and external rotation led to a Hill-Sachs type of lesion in the hip and anterior wall fracture of the acetabulum. Relocation of the hip was possible only under general anesthesia, and gross persistent instability was revealed after reduction. Poor post-operative outcomes by non-operative solutions or ORIF are widely described in the literature, and thus, we performed a total hip arthroplasty in the primary setting, with excellent post-operative outcome in 1-year follow-up and a forgotten joint.

CONCLUSION

In the rare occurrence of Hill-Sachs-like fracture-dislocation lesion of the hip, we recommend an operative solution in the primary setting, taking into consideration patient's age, intraoperative stability and defect's depth, with total hip arthroplasty being the mainstay of treatment.