Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 53 5 SM Javad Mortazavi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Hamed Mazzochy Department of Orthopedic Surgery, Shahid Modares Hospital, Saveh University of Medical Sciences, Saveh, Iran Mohammed Ghasemi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Furqan Khan Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran 2020 03 01 2020 04 11 Background: Asymmetric bilateral hip dislocation is a rare condition and the association with bilateral femoral head fracture makes it even more rare. We report a patient with asymmetric bilateral hip fracture – dislocation and our management and therapeutic approach. Case Report: A 28-year-old male sustained motor vehicle accident and presented asymmetric bilateral hip fracture-dislocation. In the initial step close reduction was performed and in the following step the patient underwent bilateral open reduction and fixation of femoral head fragment by screws. The results were satisfactory after 5 year follow-up. Conclusion: Although rare, paradoxical femoral head fracture should be considered in patients with hip dislocation. Our management and therapeutic approach seems to be appropriate for this case and is suggested in similar cases. https://jost.tums.ac.ir/index.php/jost/article/view/164 https://jost.tums.ac.ir/index.php/jost/article/download/164/154