Guerado Enrique, Cano Juan Ramón, Cruz Encarnación
Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Marbella (Malaga), Spain.
Open Orthop J. 2012;6:582-6. doi: 10.2174/1874325001206010582. Epub 2012 Dec 7.
Acetabular fractures in the elderly are increasingly common; however, an antecedent of trauma may not be known, and the diagnosis easily missed. Early identification and prompt management are needed in order to minimise morbidity rates, but little has been published on occult acetabular fracture.In this paper we present three cases of occult acetabular fracture in patients older than 75 years. All three are females and had previously been operated on the ipsilateral hip with an implant (two proximal femur fractures treated with a proximal intramedullary femoral nail, and one case of total joint replacement); these acetabular fractures could be related to the existence of a stress shielding mechanism.We believe that whenever an elderly patient feels groin pain, and anteroposterior pelvis X-rays are normal, oblique Judet projections (obturator and iliac) should be obtained. In any case, displacement will make any fracture evident within a few weeks.
老年人髋臼骨折越来越常见；然而，可能不知道有创伤史，诊断容易被漏诊。为了将发病率降至最低，需要早期识别和及时处理，但关于隐匿性髋臼骨折的报道很少。在本文中，我们介绍了3例75岁以上患者的隐匿性髋臼骨折病例。所有3例均为女性，之前同侧髋关节均接受过植入物手术（2例股骨近端骨折采用股骨近端髓内钉治疗，1例全关节置换）；这些髋臼骨折可能与应力遮挡机制的存在有关。我们认为，只要老年患者感到腹股沟疼痛，而骨盆前后位X线片正常，就应拍摄Judet斜位片（闭孔位和髂骨位）。无论如何，骨折移位会在几周内使任何骨折变得明显。
