Sanders Samuel, Tejwani Nirmal C
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 E 17th Street, New York, New York 10003, USA.
Bull NYU Hosp Jt Dis. 2008;66(4):320-6.
Bilateral asymmetric dislocations of the hip are rare compared to unilateral dislocations. This case study describes a female restrained passenger involved in a motor vehicle accident who sustained asymmetric bilateral hip dislocations. The patient underwent successful closed reduction of both hips. The clinical course and follow-up assessment of the patient was otherwise uneventful. Computed tomography scans, essential for diagnosing intra-articular loose bodies and subtle fractures, were performed after reduction and revealed in the right hip a nondisplaced acetabular rim fracture of the posterior wall on the side of the posterior dislocation. Hip dislocations are an injury requiring careful trauma evaluation to rule out concomitant injuries. Time to presentation and, more importantly, reduction of a hip dislocation, is essential in treating this injury and preventing long-term complications, such as avascular necrosis and posttraumatic arthritis. The incidence, anatomy, mechanism of injury, treatment options, and long-term sequelae of hip dislocation, with literature review, are discussed.
与单侧髋关节脱位相比,双侧不对称性髋关节脱位较为罕见。本病例研究描述了一名在机动车事故中受约束的女性乘客,她双侧髋关节发生了不对称脱位。患者双侧髋关节成功进行了闭合复位。患者的临床病程及随访评估并无其他异常情况。复位后进行了计算机断层扫描,这对于诊断关节内游离体和细微骨折至关重要,结果显示右侧髋关节后脱位侧后壁存在无移位的髋臼缘骨折。髋关节脱位是一种需要仔细进行创伤评估以排除合并伤的损伤。就诊时间,更重要的是髋关节脱位的复位时间,对于治疗这种损伤并预防长期并发症(如缺血性坏死和创伤后关节炎)至关重要。本文将结合文献综述讨论髋关节脱位的发病率、解剖结构、损伤机制、治疗选择及长期后遗症。