Case Report – Fracture & Displacement

A 33-year-old man was admitted to the emergency department after a motorcycle accident. Clinical examination of the intubated patient showed a hard, swollen, bluish scrotum and an externally rotated and slightly shortened left leg. Computed tomography (CT) of the pelvis revealed dislocation of the left hip and a three-part trochanteric fracture of the proximal left femur , with displacement of the femoral head and neck fragment into the scrotum (yellow arrow). There were also fractures of the left anterior pelvic ring and acetabulum ( blue arrow) and open fractures of the right forearm and hand. The femoral head and neck fragment was retrieved by means of a direct scrotal incision , and the fractures were treated with open reduction and internal fixation . The patient had no urologic sequelae. After 8 weeks of limited weight-bearing, the patient was able to walk with a cane. There was no evidence of avascular necrosis of the femoral head on the 3-month follow-up CT scan. At 14 months of follow-up, a CT scan showed vital bone structure and still no avascular necrosis of the femoral head, and the patient was able to walk freely without a cane.

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