Richardson P, Young J W, Porter D
Department of Diagnostic Radiology, University of Maryland Medical Systems, Baltimore 21201.
AJR Am J Roentgenol. 1990 Jul;155(1):93-4. doi: 10.2214/ajr.155.1.2112874.
Posterior dislocation of the femoral head is a common injury in automobile accidents and is frequently associated with fractures of the posterior acetabular rim. Fractures of the anterior cortex of the femoral head have not been described. One hundred sixty-four cases of posterior hip dislocation presenting consecutively to our shock trauma unit and emergency department during a 3-year period were evaluated with plain film radiology and CT. In 21 cases (13%), CT showed an anterior cortical fracture of the femoral head that could not be seen on plain radiographs. This injury is similar to the Hill-Sachs lesion of the humerus that results from anterior dislocation. The anterior cortical fracture was associated with fractures of the posterior acetabulum in 18 cases (86%). The anterior fracture is caused by impaction of the anterior femoral head against the posterior acetabular rim at the time of dislocation. We conclude that anterior cortical fracture of the femoral head is a common accompaniment to posterior acetabular dislocation.
股骨头后脱位是汽车事故中的常见损伤，常伴有髋臼后缘骨折。股骨头前皮质骨折此前未见报道。在3年时间里，连续有164例髋关节后脱位患者被送至我们的创伤休克治疗单元和急诊科，接受了X线平片和CT检查。21例（13%）患者的CT显示存在股骨头前皮质骨折，而X线平片上未见此骨折。这种损伤类似于因前脱位导致的肱骨Hill-Sachs损伤。18例（86%）患者的前皮质骨折伴有髋臼后缘骨折。前骨折是由于脱位时股骨头前部撞击髋臼后缘所致。我们得出结论，股骨头前皮质骨折是髋臼后脱位的常见伴随损伤。
