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[与明显创伤性主动脉瓣破裂相关的髋关节骨折脱位(皮普金IV型)。病例报告]

[Hip fracture-dislocation (Pipkin type IV) associated with an apparent traumatic aortic valve rupture. Case history].

作者信息

Göğüş A, Akpinar S, Unal M, Sönmez B, Hamzaoğlu A

机构信息

Kadir Has Universitesi Tip Fakültesi Florence Nightingale Hastanesi Abide-i Hürriyet cad. No. 290 Sişli, Istanbul.

出版信息

Ulus Travma Derg. 2001 Jan;7(1):66-9.

Abstract

Traumatic aortic valve rupture with resultant aortic insufficiency is a rare complication of blunt trauma. Here reported is a case with a posterior fracture-dislocation of the hip (Pipkin type-IV) and an undisplaced sternum fracture who developed hemodynamic instability in the clinical follow-up and was diagnosed having a traumatic aortic valve rupture using echocardiography. He first was treated with a biological valve replacement. Two weeks later a total hip arthroplasty combined with the osteosynthesis of the posterior wall of the acetabulum was performed. Sternum fracture healed conservatively. In multiply injured patients especially with a blunt thorax trauma hemodynamic instability despite appropriate fluid replacement should rise the suspicion of cardiac injuries, especially traumatic aortic valve rupture. Echocardiography is a simple but reliable method for the diagnosis.

摘要

创伤性主动脉瓣破裂导致主动脉瓣关闭不全是钝性创伤的一种罕见并发症。本文报道了1例髋关节后脱位骨折(皮普金IV型)和胸骨无移位骨折的患者,其在临床随访中出现血流动力学不稳定,经超声心动图诊断为创伤性主动脉瓣破裂。该患者首先接受了生物瓣膜置换术。两周后,进行了全髋关节置换术并联合髋臼后壁接骨术。胸骨骨折采取保守治疗愈合。在多发伤患者中,尤其是钝性胸部创伤患者,尽管进行了适当的液体复苏仍出现血流动力学不稳定,应怀疑有心脏损伤,特别是创伤性主动脉瓣破裂。超声心动图是一种简单但可靠的诊断方法。

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