Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Sports Medicine - Hip
Abstract number: 23387
UNUSUAL HIP INJURY FOLLOWING RUGBY TACKLE
Santosh VENKATACHALAM, Nima HEIDARI, Tony GREER
Southend University Foundation Hospital, Southend (UNITED KINGDOM)
A 28 year old amateur rugby player presented to emergency with pain in the right hip
following rugby tackle. He was involved in a scrum during the match when he to the
ground opponent from the front. All movements of the affected hip were restricted. Xray/Judet
views/ CT scan with 3D reconstruction of the pelvis revealed a posteriorfracture
dislocation of hip. CT showed small area of indentation in femoral head with
large fragment from the acetabular posterior wall and no incarcerated fragments in
the joint. Immediate closed reduction was performed. The fracture was fixed using
Langenback approach with two lag screws and reconstruction plate. He was
mobilized non-weightbearing for 4 weeks. The fracture united satisfactorily with no
evidence of avascular necrosis at two years. Rugby is a very popular contact sport in
the United Kingdom/Europe. Hip injuries can be misdiagnosed as sprain. The
characteristic fractured acetabular posterior lip and the indentation of the femoral
head confirms the force vector of flexed, adducted and internally rotated leg. Prompt
reduction is of paramount importance to decrease the risk of subsequent
osteonecrosis, heterotrophic ossification/sciatic nerve injury. Operative treatment is
required to achieve anatomical reduction of acetabular fracture, rigid fixation and
early mobilization. Our case report highlights the importance of prompt recognition of
this injury. Also of note is the unusual mechanism of injury in that the tackle was from
the front. Immediate reduction of dislocation, anatomical reduction of fracture
fragment, rigid fixation and early mobilization lead to good results.
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