A patient involved in a high-speed road traffic accident is positioned in the ambulance with the right hip flexed, adducted, and internally rotated with a shortened limb. No fracture is visible on the AP pelvis X-ray. The diagnosis is:

• A Posterior dislocation of the hip ✓
• B Intertrochanteric fracture of femur
• C Central acetabular fracture-dislocation
• D Fracture neck of femur with displacement

Explanation

Posterior dislocation of the hip is the commonest type of traumatic hip dislocation, typically caused by a dashboard injury where force is transmitted along the femoral shaft with the hip flexed and adducted. The classical position is flexion, adduction, and internal rotation with apparent shortening. Sciatic nerve injury accompanies posterior dislocation in 10–15% of cases and the hip must be reduced urgently to minimise the risk of avascular necrosis.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.