Marecek Geoffrey S, Routt M L Chip
Orthopedics. 2014 Sep;37(9):603-6. doi: 10.3928/01477447-20140825-04.
Traumatic fracture-dislocation of the hip usually warrants prompt management by closed manipulative reduction. In some patients, debris malpositioned between the femoral head and the acetabular dome obstructs a completely concentric reduction of the injured hip. To avoid damage to the articular surfaces, the debris between them should be removed in a timely fashion. Techniques for removal include open approaches with or without fracture fixation or hip arthroscopy. Fracture fixation and hip arthroscopy have associated risks and potential complications, may require special equipment, and may not be familiar to all surgeons. The authors present a simple fluoroscopically guided technique for the percutaneous removal of intra-articular debris between the femoral head and the acetabular dome after traumatic femoral head or acetabular fracture-dislocation.
髋部创伤性骨折脱位通常需要通过闭合手法复位进行及时处理。在一些患者中,位于股骨头和髋臼顶之间的碎片位置不当会妨碍受伤髋关节的完全同心复位。为避免损伤关节面,应及时清除它们之间的碎片。清除技术包括有或无骨折固定的开放入路或髋关节镜检查。骨折固定和髋关节镜检查存在相关风险和潜在并发症,可能需要特殊设备,并且并非所有外科医生都熟悉。作者介绍了一种简单的透视引导技术,用于在创伤性股骨头或髋臼骨折脱位后经皮清除股骨头和髋臼顶之间的关节内碎片。