Traumatic testicular dislocation is a rare consequence of high-energy blunt trauma, such as motor vehicle accidents. Dislocations typically occur through common anatomical routes like the inguinal canal or perineum. However, exteriorization through a penile defect, particularly sub-coronal, is exceedingly rare and under-reported. This case presents a unique instance of traumatic unilateral testicular dislocation following a high-speed motorbike accident, with exteriorization through a sub-corona penile defect.

A 29-year-old male was involved in a high-speed motorbike accident, presenting with severe genital pain and a visible penile defect. Upon physical examination, the right testicle was found exteriorized through a sub-coronal defect of the penis. Imaging, including bedside scrotal ultrasound and CT trauma pan scan, confirmed intact testicular vascularity and no associated pelvic injuries, aside from fractures to the ribs, femur, and radius. Immediate surgical intervention was performed to reduce the dislocated testicle and repair the penile defect.

Ultrasound confirmed intact vascularity of the exteriorized testicle with a minor epididymal hematoma. The patient underwent successful reduction of the testicle into the scrotum, and the penile defect was repaired in layers. Postoperative ultrasound indicated a normal appearance of both testes with a small right epididymal hematoma. No complications were noted during recovery, and the patient was discharged with a follow-up scheduled for four weeks.

Testicular dislocation through a sub-coronal penile defect is an extraordinarily rare injury, likely caused by high-energy trauma. Early surgical intervention is critical to reduce the risk of ischemia and preserve fertility. This case emphasizes the need for heightened awareness of atypical genital injuries following blunt trauma, as prompt recognition and management are essential to prevent long-term complications and ensure optimal patient outcomes.