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双侧股骨颈骨折继发于癫痫发作:双侧全髋关节置换术治疗。

Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: treatment by bilateral total hip arthroplasty.

机构信息

University department of Orthopaedics and Trauma Surgery, CHU A. Michallon, PO Box 217, 38043 Grenoble Cedex 09, France.

出版信息

Orthop Traumatol Surg Res. 2009 Nov;95(7):555-7. doi: 10.1016/j.otsr.2009.04.018. Epub 2009 Oct 3.

Abstract

Simultaneous bilateral femoral neck fracture following an epileptic seizure attack are rare. Open reduction and internal fixation remains the most used therapeutic option. Arthroplasty, carrying a high risk of dislocation is less often recommended. We report the favourable evolution of a 49-year-old man who benefited from a single stage bilateral total hip arthroplasty operation for his simultaneous bilateral, femoral neck fractures secondary to a generalized seizure. This nonconsensual choice, in this case, was justified on multiple grounds: surgical care delay longer than 48 hours, substantial bone displacement, borderline bone quality, adequate antiepileptic treatment efficacy and tolerance. A ceramic-on-ceramic bearing surfaces couple, a large-diameter head and a cementless implantation design together should be able to provide an acceptable longevity in a young and active patient.

摘要

癫痫发作后同时发生双侧股骨颈骨折较为罕见。切开复位内固定仍然是最常用的治疗选择。人工关节置换术因脱位风险较高,较少被推荐。我们报告了一位 49 岁男性的良好预后,他因全身性癫痫发作而导致双侧股骨颈骨折,接受了双侧全髋关节置换术一期手术治疗。在这种情况下,这种非共识性的选择是合理的:手术延迟超过 48 小时,骨移位明显,骨质量临界,抗癫痫治疗效果和耐受性良好。陶瓷对陶瓷的轴承表面结合、大头和非骨水泥植入设计应该能够为年轻、活跃的患者提供可接受的长期效果。

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