Postless hip arthroscopy in the acute setting following open reduction internal fixation for comminuted posterior wall acetabular fracture dislocation

Posterior wall acetabular fractures are commonly associated with high-energy trauma. This case report presents a 39-year-old male patient with a polytrauma after a motorcycle accident with a comminuted right posterior wall acetabular fracture with hip dislocation. He underwent closed reduction and skeletal traction, then operative fixation of the right posterior wall acetabular fracture with internal fixation on the following day. Post-operative computed tomography scan demonstrated large intra-articular loose bodies within the right hip at the cotyloid fossa. The patient subsequently underwent right hip arthroscopy with removal of loose bodies, debridement, and chondroplasty three days after initial open reduction internal fixation (ORIF). Postless traction techniques were utilized successfully. At 11-month follow-up, the patient reported no pain and had returned to normal activities as tolerated. In conclusion, the early use of hip arthroscopy following ORIF for comminuted posterior wall acetabular fracture dislocation may offer decreased morbidity and fewer long-term complications, thereby providing new clinical insights that expand current understandings of this approach.