Septic hip in pelvic fractures with urologic injury: a case report, review of the literature and discussion of the pathophysiology.

In patients with fractures of the pubic rami and acetabulum and a rupture of the bladder or urethra, there is a risk of septic arthritis developing in the traumatized hip. Infected material from the lacerated urinary tract can communicate by a fistulous tract with the hip joint. Since the symptoms of hip infection in this setting would differ significantly from acute hematogenous septic arthritis, the attending physician must be alert to this possibility for early diagnosis to be made and appropriate treatment instituted. Every attempt should be made to maintain the sterility of the urine throughout the course of treatment, in the hope of preventing the delayed sequelae of unrecognized hip infection. The possibility of this complication must be anticipated to prevent early joint destruction.