A 40-year-old male presented to the ER with history of a motor vehicle accident. The vehicle hit his car head on. The Patient was thrown forward by the sudden deceleration. His knee hit the dashboard violently, and he felt a painful pop in his right hip. The doctor on duty noted his right limb shows this deformity There is a painful mass in the lateral gluteal region. What is the most likely diagnosis?
A- Anterior hip dislocation B- Posterior hip dislocation C- Fracture neck of femur D- Gluteal muscle hematoma Posterior hip dislocation Due to deceleration injury Here the left knee was forcefully impacted the vehicle's dashboard, forcing the femoral head posteriorly over the rim of the acetabulum. As he turned to reach for the seatbelt, his hip was flexed because he was in sitting position, and was adducted and medially rotated, the classic hip position for this type of injury. The painful pop was the femoral head tearing through the posterior joint capsule and ligaments. The painful lateral gluteal mass is the femoral head on the lateral aspect of the ilium, and the affected limb appears shoer than the other because of the abnormal position of the femoral head. The first step would be radiographic confirmation of the dislocation or dislocation fracture. This would be followed by urgent reduction of the dislocation to decrease the risk of avascular necrosis of the femoral head. Fracture repair, if a fracture is present, may be performed at a later time.
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