Pawar Kapil, Kandhari Vikram Kishor
Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.
Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
J Surg Case Rep. 2016 Feb 1;2016(2):rjv177. doi: 10.1093/jscr/rjv177.
Simultaneous post-traumatic ipsilateral fracture of femur head and subcapital femur neck without hip dislocation is a rare presentation and easily missed on X-ray imaging. A 48 years old male, with a history of high-energy road traffic accident, presented to us with severe pain in the left hip region and inability to ambulate. Preliminary X-ray showed impacted subcapital fracture with varus angulation between femur head and neck. Further computed tomography (CT) scan imaging showed ipsilateral fracture of femur head and subcapital femur neck without hip dislocation. Primary total hip arthroplasty was performed. Presently patient is 5 years post-surgery and can ambulate without support. In conclusion, this fracture pattern, though rare, should be suspected in high-energy road traffic accident patients with shear forces acting at femur neck. It can best be diagnosed using 3D CT scan imaging. Primary total hip arthroplasty is an appropriate treatment in such patients.
创伤后同时发生的同侧股骨头和股骨颈基底骨折且无髋关节脱位是一种罕见的表现，在X线成像上很容易被漏诊。一名48岁男性，有高能道路交通事故史，因左髋部剧痛和无法行走前来就诊。初步X线显示股骨颈基底嵌插骨折，股骨头与颈之间有内翻成角。进一步的计算机断层扫描（CT）成像显示同侧股骨头和股骨颈基底骨折且无髋关节脱位。实施了一期全髋关节置换术。目前患者术后5年，可独立行走。总之，这种骨折类型虽然罕见，但在有作用于股骨颈的剪切力的高能道路交通事故患者中应予以怀疑。使用三维CT扫描成像能最好地进行诊断。一期全髋关节置换术对此类患者是一种合适的治疗方法。
