Miyake Takahito, Kanda Akio, Morohashi Itaru, Obayashi Osamu, Mogami Atsuhiko, Kaneko Kazuo
Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, 1129 Izunagaoka, Izunokuni, Shizuoka 410-2295, Japan.
Department of Orthopaedic Surgery, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan.
Ann Med Surg (Lond). 2017 Mar 30;18:6-9. doi: 10.1016/j.amsu.2017.03.036. eCollection 2017 Jun.
Bipolar hip arthroplasty is a good option for treating femoral neck fractures, although some contraindications have been indicated. We report a case of intraoperative dislocation of the trial bipolar cup into the pelvis during bipolar hip arthroplasty.
A 74-year-old woman underwent bipolar hip arthroplasty for a femoral neck fracture (AO31-B2). She was placed in a lateral decubitus position, and a direct lateral approach was used. During intraoperative trial reduction, the trial bipolar cup became disengaged and dislocated into the anterior space of hip joint. Several attempts to retrieve it failed. The permanent femoral component was inserted, and the wound was closed. The patient was repositioned supine to allow an ilioinguinal approach, and the component was easily removed. She had an uneventful, good recovery.
Several cases of intraoperative dislocation of the femoral trial head during total hip arthroplasty have been reported, this is the first report of dislocation of a bipolar trial cup. A previous report described difficulty retrieving a trial cup.
We easily removed our trial cup using another approach. It is vital to plan systematically for this frustrating complication.
双极髋关节置换术是治疗股骨颈骨折的一个不错选择，尽管存在一些禁忌症。我们报告一例双极髋关节置换术中试验性双极髋臼杯术中脱位至骨盆的病例。
一名74岁女性因股骨颈骨折（AO31-B2）接受双极髋关节置换术。她被置于侧卧位，采用直接外侧入路。在术中试验复位过程中，试验性双极髋臼杯脱离并脱位至髋关节前间隙。多次尝试取出均失败。插入永久性股骨部件，关闭伤口。患者重新仰卧位以便采用髂腹股沟入路，部件很容易就被取出。她恢复顺利且良好。
已有多例全髋关节置换术中股骨试验头术中脱位的病例报道，这是双极试验髋臼杯脱位的首例报道。之前有报道描述了取出试验髋臼杯存在困难。
我们通过另一种入路轻松取出了试验髋臼杯。针对这种令人沮丧的并发症进行系统规划至关重要。
