Wk 5, Case 1 - Review

Patient History: 11-yo male with with hip pain for one week after football injury
Findings
SKELETAL: Posterior acetabular rim fracture, posterior capsular tear, soft tissue swelling and a rotated/displaced comminuted 2 cm fracture fragment. Microtrabecular contusion, without macrofracture, of the medial and posterior epiphysis of the right femoral head. No physeal involvement. The remaining physes are normal.

PELVIS: Small amount of physiologic free pelvic fluid. Nondistended right testicle. Normal left testicle. No hernia.

JOINTS: Normal left hip joint. Normal symphysis pubis and SI joints.

ACETABULUM/LABRUM: Posterior labral tear. Left hip effusion.

MUSCLES/TENDONS/LIGAMENTS: Intact hamstring origins. No ischiofemoral impingement. Normal gluteus medius and minimus insertions. Normal iliopsoas tendons. Mild right gluteus medius and minimus strain. Mild right quadratus femoris strain. No muscle tear or atrophy.

OTHER/SOFT TISSUE: Symmetric piriformis muscles and sciatic nerves.

Conclusion
1. Comminuted displaced posterior acetabular fracture, capsular tear, and posterior labral tear with adjacent femoral head contusion without physeal slippage or involvement. Findings compatible with posterior subluxation versus dislocation. Intact ligamentum teres.
2. Mild right gluteal and quadratus femoris strain without tear or atrophy.
3. Nondistended right testicle, urology consultation recommended.