Femoral Head Fracture Fixation Using Femoral Head Cement Templating for Iliac Bone Graft and Biodegradable Screws via Ganz Surgical Dislocation of the Hip: A Case Report

A 22-year-old Malaysian male presented with a closed posterior dislocation of the right hip with femoral head fracture (Pipkin II) after an alleged motor vehicle accident (MVA). This type of injury may pose future complications, such as avascular necrosis, post-traumatic osteoarthritis, or heterotopic ossification to the hip joint, and later affect joint function. After an immediate closed reduction of the hip, the patient underwent Ganz Surgical dislocation of the hip - a surgical method used to aid the reconstruction of the bony defect of the femoral head. Using bone cement templating, right iliac bone graft was harvested to support the bony defect of the femoral head, and biodegradable screws were inserted to reconstruct the femoral head. The use of absorbable screws eliminated the need for a second surgery to remove hardware, reducing complications. At eight months post-operatively, the patient was able to ambulate without walking aid and fully bear weight on his right hip without pain. Imaging confirmed proper alignment and healing, with no indication for further surgery. This favorable outcome highlighted the efficacy of biodegradable screws in maintaining femoral head integrity while minimizing future surgical intervention. One year later, the patient regained excellent functional capacity, achieving a Lower Extremity Functional Scale (LEFS) score of 96.3%, indicating near-complete recovery with minimal limitations. This case report illustrates the success of using cement-templated iliac bone graft combined with biodegradable screws in femoral head fixation. The approach not only achieved structural stability but also led to a high functional outcome without the need for additional procedures. These findings support the use of absorbable fixation in complex orthopedic cases such as hip dislocations with femoral head involvement.