Total Hip Replacement for Neglected Posterior Fracture Dislocation by Dr. Anoop Jhurani

Description

This VTT transcript features a detailed surgical instructional video presented by Anoop Jhurani, focusing on the complex procedure of addressing neglected posterior fracture-dislocations of the hip. The transcript begins with an introduction to the common occurrence of posterior fracture-dislocations in patients with multiple injuries, emphasizing the need for careful assessment to prevent missing such critical conditions.



Throughout the video, Jhurani describes the case of a 30-year-old male patient who presented a year later with significant complications from untreated posterior fracture dislocation, including shortening of the hip due to arthritis. He discusses the necessary imaging techniques, such as analyzing two-dimensional and three-dimensional CT scans to correctly diagnose and plan the surgical approach.



The technique outlined involves restoring the center of rotation of the hip through careful reconstruction of the posterior wall and column using the femoral head as an autograft. Detailed steps describe how to reshape and secure the grafts, ensuring they properly cover the existing defects, and how to accurately set the position of the hip socket to avoid complications such as dislocation and biomechanical issues.



Jhurani emphasizes the importance of maintaining limb length and offset during the procedure, alongside achieving proper cup placement with a highly porous implant to ensure stable fixation. He concludes with guidance on post-operative care and the importance of restoring function without compromising structural integrity. The overarching message is the critical need to avoid chasing the false acetabulum and to meticulously build up the posterior wall defect while keeping the anatomical alignment intact.

Specialties