Challenges and solutions in the fixation of a hip fracture in the presence of a contralateral ankylosed hip: a case report

Abstract

Background An intracapsular femoral neck fracture is a common orthopaedic presentation and requires expedient fixation in a young adult. This case demonstrates how patient-specific factors, namely an ankylosed contralateral hip, can make a common operation challenging. Case Description A 22-year-old man with osteogenesis imperfecta and multiple bony deformities was brought to A&E after being involved in a motor vehicle collision. Plain radiographs and clinical examination demonstrated a right intracapsular femoral neck fracture, ipsilateral femora vara and a contralateral ankylosed hip secondary to protrusio acetabuli. The intraoperative patient and fluoroscopic positioning were technically challenging. Clinical Relevance Preoperative literature review revealed no operative strategy or case report describing how best to perform closed reduction and internal fixation of a femoral neck fracture with a co-existing contralateral ankylosed hip joint. We hope our experience will aid other surgeons who find themselves in a similar clinical scenario. We will present the difficulties faced and the adaptations made to our surgical technique which we utilised to achieve an anatomical fixation.