Berg Andrew James, Bhatia Chandra
Department of Trauma and Orthopaedics, North Tees and Hartlepool NHS Foundation Trust, Stockton on Tees, UK.
BMJ Case Rep. 2014 Feb 21;2014:bcr2013203504. doi: 10.1136/bcr-2013-203504.
While neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons.
虽然股骨颈骨折很常见,但在双侧下肢截肢患者中出现这种损伤却很罕见。需要对这些患者的治疗给予特别考虑。我们报告了一例58岁双侧下肢截肢男性患者,因跌倒后出现左髋部疼痛而就诊于急诊科。诊断为左股骨颈骨折并延伸至股骨干。计划采用动力髋螺钉进行内固定。由于截肢,在这种情况下无法采用标准的骨折手术台设置,该设置允许对骨折肢体进行牵引并对侧肢体定位,以便获得前后位和侧位X线片。我们强调了在为双侧截肢患者进行股骨颈骨折固定时需要考虑的因素,并突出了一种其他外科医生可以采用的临时技术。