Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature

Introduction: Isolated quadrilateral plate fracture with central hip dislocation is a rare occurrence. Such difficult-to-treat fractures can be managed with both open reduction and internal fixation (ORIF) and total hip arthroplasty (THA). We hereby describe the management of such a case of neglecte...

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Main Authors: Somok Banerjee, Santu Sarkar, Alok Chandra Agrawal, Harshal Sakale, Suhas Mahendrakar, Devashish Singh
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-07-01
Series:Journal of Orthopaedic Case Reports
Subjects:
Online Access:https://jocr.co.in/wp/2025/07/01/total-hip-arthroplasty-in-a-case-of-neglected-central-hip-dislocation-with-isolated-quadrilateral-plate-fracture-a-case-report-with-review-of-literature/
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author Somok Banerjee
Santu Sarkar
Alok Chandra Agrawal
Harshal Sakale
Suhas Mahendrakar
Devashish Singh
author_facet Somok Banerjee
Santu Sarkar
Alok Chandra Agrawal
Harshal Sakale
Suhas Mahendrakar
Devashish Singh
author_sort Somok Banerjee
collection DOAJ
description Introduction: Isolated quadrilateral plate fracture with central hip dislocation is a rare occurrence. Such difficult-to-treat fractures can be managed with both open reduction and internal fixation (ORIF) and total hip arthroplasty (THA). We hereby describe the management of such a case of neglected irreducible central hip dislocation with quadrilateral plate fracture with THA in this case report. Case Report: A 55-year-old male patient presented to our outpatient department with 5 month old neglected post-traumatic central dislocation of the hip with a quadrilateral plate fracture. Initially, ORIF with infrapectineal plating was planned by anterior intra-pelvic approach. But despite best efforts (lateral and longitudinal traction along with reduction tools and maneuvers) it was not possible to reduce the head femur back into the native acetabular floor due to the long-standing napkin ring constriction. It was decided intra-operatively to proceed with THA. The patient was subsequently repositioned for THA using a standard posterior approach. The head femur was removed piecemeal and the medial wall defect was reconstructed using contoured titanium mesh with impaction bone grafting and rest THA was done in the usual manner. The patient was mobilized from 2nd post-operative day and allowed partial weight bearing with gradual progression to full weight bearing by 3rd week. He could return to his daily activities by 6 months and had a Modified Harris Hip Score of 91 in 1 year follow-up. Radiographs revealed well incorporation of the bone graft with no evidence of loosening. The patient didn’t have any complications such as infection. Heterotopic ossification or dislocation. Conclusion: THA in neglected irreducible central hip dislocation with quadrilateral plate fracture has good functional and radiological outcome.
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spelling doaj-art-54247a4ce0df41a2b0ea7e2914d0c4ce2025-08-20T03:36:45ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-07-0115713714110.13107/jocr.2025.v15.i07.5798Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of LiteratureSomok BanerjeeSantu SarkarAlok Chandra AgrawalHarshal SakaleSuhas MahendrakarDevashish SinghIntroduction: Isolated quadrilateral plate fracture with central hip dislocation is a rare occurrence. Such difficult-to-treat fractures can be managed with both open reduction and internal fixation (ORIF) and total hip arthroplasty (THA). We hereby describe the management of such a case of neglected irreducible central hip dislocation with quadrilateral plate fracture with THA in this case report. Case Report: A 55-year-old male patient presented to our outpatient department with 5 month old neglected post-traumatic central dislocation of the hip with a quadrilateral plate fracture. Initially, ORIF with infrapectineal plating was planned by anterior intra-pelvic approach. But despite best efforts (lateral and longitudinal traction along with reduction tools and maneuvers) it was not possible to reduce the head femur back into the native acetabular floor due to the long-standing napkin ring constriction. It was decided intra-operatively to proceed with THA. The patient was subsequently repositioned for THA using a standard posterior approach. The head femur was removed piecemeal and the medial wall defect was reconstructed using contoured titanium mesh with impaction bone grafting and rest THA was done in the usual manner. The patient was mobilized from 2nd post-operative day and allowed partial weight bearing with gradual progression to full weight bearing by 3rd week. He could return to his daily activities by 6 months and had a Modified Harris Hip Score of 91 in 1 year follow-up. Radiographs revealed well incorporation of the bone graft with no evidence of loosening. The patient didn’t have any complications such as infection. Heterotopic ossification or dislocation. Conclusion: THA in neglected irreducible central hip dislocation with quadrilateral plate fracture has good functional and radiological outcome.https://jocr.co.in/wp/2025/07/01/total-hip-arthroplasty-in-a-case-of-neglected-central-hip-dislocation-with-isolated-quadrilateral-plate-fracture-a-case-report-with-review-of-literature/central hip dislocationquadilateral plate fracturetotal hip arthroplastyimpaction bone grafting
spellingShingle Somok Banerjee
Santu Sarkar
Alok Chandra Agrawal
Harshal Sakale
Suhas Mahendrakar
Devashish Singh
Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
Journal of Orthopaedic Case Reports
central hip dislocation
quadilateral plate fracture
total hip arthroplasty
impaction bone grafting
title Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
title_full Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
title_fullStr Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
title_full_unstemmed Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
title_short Total Hip Arthroplasty in a Case of Neglected Central Hip Dislocation with Isolated Quadrilateral Plate Fracture: A Case Report with Review of Literature
title_sort total hip arthroplasty in a case of neglected central hip dislocation with isolated quadrilateral plate fracture a case report with review of literature
topic central hip dislocation
quadilateral plate fracture
total hip arthroplasty
impaction bone grafting
url https://jocr.co.in/wp/2025/07/01/total-hip-arthroplasty-in-a-case-of-neglected-central-hip-dislocation-with-isolated-quadrilateral-plate-fracture-a-case-report-with-review-of-literature/
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