A 25-year-old male sustains a posterior dislocation of the hip in a road traffic accident. After closed reduction, the MOST important next step is:

• A Hip spica cast for 6 weeks
• B X-ray of the pelvis every 4 weeks for avascular necrosis monitoring
• C Crutch walking with immediate full weight-bearing
• D CT scan of the hip to exclude intra-articular fragments and acetabular fracture ✓

Explanation

After successful closed reduction of a posterior hip dislocation, CT scan is mandatory to detect osteochondral fragments within the joint, associated acetabular fractures (Pipkin classification), and adequacy of reduction. Intra-articular fragments not identified on plain X-ray can cause chondrolysis and early post-traumatic arthritis. CT guides the decision for surgical removal of fragments or ORIF of acetabular fractures. Avascular necrosis monitoring with MRI is important later (6 weeks to 1 year) but CT is the immediate priority.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.