Baker Joseph F, Leonard Michael, Devitt Brian M, Queally Joseph M, Noel Jacques
Department of Orthopaedic Surgery, Adelaide and Meath Incorporating the National Children's Hospital, Dublin, Ireland.
Pediatr Emerg Care. 2011 Dec;27(12):1178-9. doi: 10.1097/PEC.0b013e31823b0e71.
Traumatic hip dislocation in the pediatric patient requires much less energy than in an adult, yet it remains a rare diagnosis. We report the case of a 3-year-old girl who dislocated her right hip when bindings failed to release as she skied downhill. The hip was promptly reduced in the nearest trauma center, and at 18 months after injury, there is no evidence of avascular necrosis. The potential risk of avascular necrosis is significant, and the risk rises greatly when reduction is delayed beyond 6 hours. Reduction can be safely performed in the emergency department, although up to 25% of cases will require open reduction in the operating room. A high index of suspicion is warranted to not miss the "golden window" and achieve satisfactory reduction in a timely fashion.
小儿创伤性髋关节脱位所需的能量比成人少得多,但仍然是一种罕见的诊断。我们报告了一例3岁女孩的病例,她在滑雪下坡时固定装置未能松开,导致右髋关节脱位。该髋关节在最近的创伤中心迅速得到复位,受伤18个月后,没有无血管坏死的迹象。无血管坏死的潜在风险很大,当复位延迟超过6小时时,风险会大大增加。虽然高达25%的病例需要在手术室进行切开复位,但在急诊科可以安全地进行复位。需要高度怀疑,以免错过“黄金窗口”,并及时实现满意的复位。