Spontaneous non-traumatic dislocation of the hip as a complication of screw-plate fixation of a femoral neck fracture

Abstract

Femoral neck fractures are commonly seen in elderly population as a cause of a trivial fall. In younger patients it usually occurs following high energy trauma. Dynamic hip screw (DHS) is one of the most common type of internal fixation although intramedullary fixation devices have been introduced in the treatment in the last decade not without controversy [1,2]. Described complications are failure of fixation, cut-out, malunion, non-union, disengagement of lag screw and side plate, cut-in, intrapelvic migration, vascular injuries, etc. Despite its technical complexity, fixation of these fractures is done every day all over the world with recent evidence supporting selection of DHS in favor of intramedullary nailing2. Dislocation of the hip following a DHS is a very rare complication. There are only a few cases described in literature, some of them associated with infection. We present a case of a spontaneous non-traumatic dislocation of the hip as a complication of screw-plate fixation of a femoral neck fracture and an exhaustive review of literature discussing the possible causes of this rare complication.