Henderson L, Johnston A, Mockford B, Craig B
Royal Victoria Hospital, Belfast, UK.
J Surg Case Rep. 2012 Oct 1;2012(10):14. doi: 10.1093/jscr/2012.10.14.
It is accepted that a traumatic hip dislocation is a surgical emergency, this holds for the uncommon dislocation of the hip with femoral neck fracture however the surgical dilemma involves head salvage or replacement. This case report describes the method and technique for stabilisation of the rare and challenging isolated posterior hip dislocation with an ipsilateral femoral neck fracture. A 38-year-old gentleman was involved in a high-speed road traffic collision sustaining a posterior dislocation with ipsilateral femoral neck fracture. This was managed emergently with open reduction and osteosynthesis. The technique was by the modified placement of three cannulated screws through a posterior approach. The use of antegrade guide wires allowed accurate placement in a triangular configuration and temporary fixation to facilitate hip reduction prior to retrograde insertion of three 6.5mm cannulated screws. The patient, although developing radiological avascular necrosis, continues to work and has returned to hobbies at 4.5 years.
外伤性髋关节脱位被公认为是一种外科急症，对于伴有股骨颈骨折的罕见髋关节脱位也是如此，然而手术困境在于股骨头的挽救或置换。本病例报告描述了治疗罕见且具有挑战性的孤立性髋关节后脱位合并同侧股骨颈骨折的稳定方法和技术。一名38岁男性在高速道路交通碰撞中受伤，导致髋关节后脱位并伴有同侧股骨颈骨折。对此进行了急诊切开复位和骨固定术。该技术是通过后入路改良置入三根空心螺钉。使用顺行导丝可将螺钉准确呈三角形置入，并进行临时固定，以便在逆行插入三根6.5mm空心螺钉之前进行髋关节复位。该患者虽出现了放射性股骨头缺血性坏死，但仍继续工作，并在4.5年后恢复了爱好。
