Acute total hip arthroplasty for anterior hip fracture–dislocation: a case report

Hip fracture-dislocations accompanied by femoral head or acetabular fractures remain challenging, and the optimal treatment strategy is still controversial. Anterior hip fracture-dislocations are particularly rare, and reports describing acute total hip arthroplasty (THA) for this injury pattern are limited. We report the case of a 74-year-old active woman who sustained an anterior hip fracture-dislocation with femoral head and acetabular anterior wall fractures after a low-energy fall. The injury was classified as Pipkin type IV and Brumback type 4B. Following closed reduction, acute THA was performed via a posterior approach using a dual mobility cup without additional internal fixation, as adequate acetabular coverage and primary stability were achieved intraoperatively. Immediate full weight-bearing was allowed. At 6 months postoperatively, the patient had resumed recreational sports, with a Harris Hip Score of 92 and no complications. Acute THA may be a viable treatment option for selected anterior hip fracture-dislocations.