Dislocation of the hip, complicated by a fracture of the shaft of the femur, is an exceedingly rare condition and presents a most difficult problem in reduction. It is a well-known fact that this type of injury occurs in young and middle-aged adults most frequently, and is caused by only the most violent forms of trauma. For this reason, it is usually seen in a very muscular type of patient, which makes closed reduction even more difficult.
The problem in reduction arises from the fact that the lever arm, the femur, is not intact and one has no control over the proximal fragment. The authors were able to restore the lever arm by means of the gas-pipe extension on the pin-fixation apparatus, and thus were successful in the reduction.
The authors feel that non-union developed because of the excessive stripping of the periosteum from the proximal fragment, caused by the marked displacement resulting from the dislocation of the hip. The increase in density of the proximal portion of the shaft of the femur, probably due to the damage to the blood supply secondary to the periosteal stripping, is shown in Figure 5-A.
Division of Orthopaedic Surgery, Henry Ford Hospital, Detroit