Alexa O, Puha B, Veliceasa B, Păduraru D
Department of Orthopedics and Trauma, University of Medicine and Pharmacy Iaşi, Romania.
Chirurgia (Bucur). 2009 Nov-Dec;104(6):761-4.
Hip dislocations are a frequent consequence of traffic accidents. Commonly, the knee hits the car board and the force of the impact leads to either a fracture of the femur or a dislocation of the hip. The dislocation occurs if the femur does not break and the force of the impact is transmitted towards the hip joint leading to a posterior dislocation of the femoral head. We present the case of a 41 year old patient involved in a traffic accident that suffered a knee injury. Clinical and imagistic (radiography, CT) examination revealed a trochanteric fracture associated with a posterior hip dislocation. Such associations are very rare and can be explained by an extremely powerful force of impact that generated the two lesions simultaneously. Open reduction of the dislocation was performed after handling the superior femoral extremity with the aid of an instrument that was introduced through the fracture site. After the dislocation was treated, the trochanteric fracture was reduced and fixation was obtained with a Dynamic Hip Screw. The case is important not only because of its extreme rarity but also because of the chosen treatment method. Few similar cases are quoted in present literature.
髋关节脱位是交通事故的常见后果。通常,膝盖撞击汽车仪表盘,撞击力会导致股骨骨折或髋关节脱位。如果股骨未骨折,撞击力会传递至髋关节,导致股骨头后脱位,就会发生脱位。我们报告一例41岁交通事故患者,该患者膝部受伤。临床及影像学(X线、CT)检查显示为转子间骨折合并髋关节后脱位。这种关联非常罕见,可解释为产生这两种损伤的撞击力极其强大。在通过骨折部位插入器械处理股骨上端后,进行了脱位的切开复位。脱位治疗后,对转子间骨折进行复位,并用动力髋螺钉固定。该病例不仅因其极为罕见而重要,还因其所采用的治疗方法而重要。目前文献中很少引用类似病例。