Ceylan Halil, Selek Ozgur, Sarlak Ahmet Y
Department of Orthopaedics and Traumatology, Van İpekyolu State Hospital, 65100 Van, Turkey.
Case Rep Orthop. 2013;2013:842390. doi: 10.1155/2013/842390. Epub 2013 Jun 17.
Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.
在发达国家,每百万人口中进行肾移植的例数在30至60例之间。移植肾通常置于髂窝;因此,对于这些患者的骨盆创伤治疗程序应谨慎选择。治疗移位髋臼骨折的金标准技术是切开复位内固定。我们的患者因慢性肾衰竭接受了亲属活体供肾肾移植。在移植后的第二年,她在一次机动车事故中受伤,X线片显示右侧髋臼前柱骨折和左侧耻骨支骨折。该患者接受了经皮固定技术治疗,术后一年没有退变迹象,临床结果良好。除了具有避免通过标准髂腹股沟入路切开髂窝的优点外,经皮技术手术时间短、减少软组织损伤且有早期出院的可能,对于感染风险较高的肾移植受者可能是理想的选择。对肾移植受者的特定髋臼骨折进行经皮固定可能有降低与传统开放手术相关的发病率的潜力。