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Review Question - QID 586

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QID 586 (Type "586" in App Search)
A 41-year-old female sustains the injury shown in Figure A as a result of a high-speed motor vehicle collision. After a successful attempt at closed reduction in the emergency room using conscious sedation, repeat radiographs show a reduced hip joint. What is the next most appropriate step in treatment?
  • A

Femoral skeletal traction

3%

75/2335

CT scan of hip and pelvis

87%

2041/2335

Dynamic fluoroscopic examination under general anesthesia

6%

136/2335

Hip spica dressing

0%

7/2335

Touch down weight bearing mobilization

3%

68/2335

  • A

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The radiograph shown in Figure A reveals a left hip dislocation, with some obscuring of detail secondary to the trauma backboard. CT scans should be obtained following a hip dislocation to evaluate for fractures or impacted areas of the femoral head or acetabulum, as well as noncongruent reductions and free intraarticular joint fragments.

The referenced study by Brumback et al comments on the importance of post-reduction CT scans and found that 23% of their posterior wall fractures had associated marginal impaction, with 94% of these discovered via preoperative CT scan.

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