Labral repair restoring stability in a mildly dysplastic hip with concomitant femoral head and neck fracture-dislocation: a case report

Posterior hip dislocations with simultaneous femoral head and neck fractures are extremely rare, usually after high-velocity trauma, and demand urgent surgery to prevent complications. A 40-year-old woman sustained a posterior dislocation with femoral head fracture after a low-energy twisting fall. A forceful closed reduction without relaxation caused an iatrogenic femoral neck fracture (Pipkin Type III). She underwent open reduction and internal fixation within six hours of presentation (28 h after injury). Redislocation occurred on day 20 due to unrecognised labral avulsion and acetabular dysplasia, later addressed with labral repair. At two years, she remained pain-free with good functional scores, although the femoral head was not perfectly concentrically reduced on final radiographs, a finding attributed to the underlying dysplasia; she was subsequently lost to follow-up. This case illustrates that good short-term function can be achieved despite imperfect radiographic congruency, while underscoring the importance of recognising dysplasia and labral injury and of considering arthroplasty as an alternative in this fracture pattern.