Open anterior hip dislocation combined with infection and injury of the common femoral artery and vein: A case report and literature review.

RATIONALE

Open anterior hip dislocation resulting in vascular injury is extremely rare and is a severe orthopedic emergency that can potentially lead to limb necrosis and even life-threatening consequences.

PATIENT CONCERNS

A 51-year-old woman presented to our hospital with an open anterior dislocation of the left hip secondary to a fall from height. The patient had a severe infection in the left inguinal area; at presentation, there was dislocation of the femoral head lasting for the past 5 days. Doppler ultrasound revealed left common femoral vein thrombosis.

DIAGNOSES

The patient was diagnosed with a multiple-injury patient with an acetabular fracture, femoral head fracture, and open anterior dislocation of the hip with vascular injury and infection.

INTERVENTIONS

After placement of an inferior vena cava filter, the reduction was performed under general anesthesia. The common femoral artery ruptured during the process. After suturing, continuous drainage was maintained. During the subsequent treatment, the infection gradually eroded the common femoral artery and formed a pseudoaneurysm. Lower limb vascularity was restored by autologous saphenous vein grafting, repeated debridement, and sensitive antibiotics.

OUTCOMES

The infection of the patient was gradually controlled, and the lower limb was successfully preserved. During the 1-year follow-up, the patient returned to normal life without disability.

LESSONS

From this rare case, we suggest that a therapeutic approach should be evaluated after adequate exclusion of deep vein thrombosis to prevent thromboembolic events. Moreover, gentle reduction operation, thorough debridement, and timely infection control are essential to prevent complications and improve the functional prognosis of patients.