Tiedeken Nathan C, Saldanha Vilas, Handal John, Raphael James
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA
Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA.
J Surg Case Rep. 2013 Oct 4;2013(10):rjt075. doi: 10.1093/jscr/rjt075.
A floating hip injury occurs in the setting of poly-trauma and is a rare and difficult problem to manage. Floating hip injuries require vigilant attention not only to the osseous injuries but also the surrounding compartments and soft tissue envelope. We report the case of a 35-year-old male with a lower extremity posterior wall acetabular fracture, ipsilateral femoral shaft fracture and a postero-superior hip dislocation. Closed reduction failed, necessitating an open reduction internal fixation of his hip dislocation and acetabular fracture. The patient then developed a thigh compartment syndrome requiring a fasciotomy. Despite the obvious bony injuries, orthopedic surgeons must be vigilant of the neurovascular structures and soft tissues that have absorbed a great amount of force. A treatment plan should be formulated based on the status of the overlying soft tissue, fracture pattern and the patient's physiologic stability.
浮动髋损伤发生于多发伤情况下，是一种罕见且处理困难的问题。浮动髋损伤不仅需要密切关注骨损伤，还需关注周围的肌间隔和软组织包膜。我们报告一例35岁男性患者，其患有下肢后壁髋臼骨折、同侧股骨干骨折以及后上方髋关节脱位。闭合复位失败，因此需要对其髋关节脱位和髋臼骨折进行切开复位内固定。该患者随后出现大腿骨筋膜室综合征，需要进行筋膜切开术。尽管存在明显的骨损伤，但骨科医生必须警惕吸收了大量力量的神经血管结构和软组织。应根据覆盖软组织的状况、骨折类型和患者的生理稳定性制定治疗方案。
