Introduction: Inferior dislocation of the hip, also called luxatio erecta femoris, is the rarest type of hip dislocation with a poorly understood mechanism of injury. We came across three such cases resulting from high-energy trauma with various other associated injuries. Case Report: The first patient, a 25-year-old man, presented with the right hip pain, hip and knee joint in flexion without rotational component, after motor vehicle collision. The second patient, a 42-year-old man, presented with the left hip pain, hip and knee joint in flexion with rotational component, following fall from 20 ft height. The third patient, a 29-year-old lady, presented with the left hip pain, hip and knee joint in flexion with rotational component, after motor vehicle collision. All three patients were diagnosed by radiograph and were managed by closed reduction under short general anesthesia, within 3 h, 9 h, and 6 h, respectively. Thomas splint was used to immobilize the limb in all for 1 month and weight-bearing was started after 2 months from injury. Two of them were followed up to 6 months and one was lost to follow up. No evidence of avascular necrosis of femoral head or other complication related to hip dislocation was noted. Conclusion: Luxatio erecta femoris is a rare type of hip dislocation and with limited publication. The position of limb on presentation should raise the suspicion of same and diagnosis confirmed through radiological investigations. Usually, this type of dislocation can be managed with closed reduction. If closed reduction is unsuccessful, then a fracture femur or bone chip in the joint could be the cause of the difficulty. Keywords: Hip, dislocation, inferior, luxatio erecta femoris.
Background: Incidence of fracture shaft of clavicle is increasing in young population due to increase incidence of road traffic accident. Conventionally plate and screw fixation has been the choice, but to avoid complications like soft tissue problem, hardwire prominence, nonunion etc, a less invasive method like intramedullary fixation is desirable. Materials and Methods: This prospective study was conducted in orthopaedic Deptt. of IPGMER and SSKM Hospital, Kolkata during January 2015 to August 2017 on 30 adult patients with fresh closed fractures of mid shaft of clavicle. Patients with open fractures, pathological fractures, and grossly comminuted fractures were excluded. All the nails were introduced through medial side of clavicle under fluoroscopic guidance and open reduction with minimum tissue dissection when closed reduction not possible. All patients were follow up for one and half year for results in terms of time to union, operative complications, functional score etc. Results: All the fractures united within a reasonable period with good functional result in respect to constant-murley shoulder score with less complications. Conclusion: Intramedullary fixation, like TENS nail is a good viable option in displaced midshaft fracture of clavicle.
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