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创伤性髋关节脱位:骨科医生想知道的。

Traumatic Hip Dislocation: What the Orthopedic Surgeon Wants to Know.

机构信息

From the Department of Radiology (J.C.M., R.A.M., A.D.S., B.K.), Division of Musculoskeletal Imaging and Intervention (J.C.M.), Division of Emergency Radiology (A.D.S., B.K.), and Department of Orthopedic Surgery (M.J.W., M.B.H.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.

出版信息

Radiographics. 2017 Nov-Dec;37(7):2181-2201. doi: 10.1148/rg.2017170012.

Abstract

Hip dislocation is an important orthopedic emergency usually seen in young patients who have experienced high-energy trauma, often resulting in significant long-term morbidity. Rapid identification and reduction is critical, as prolonged dislocation increases the risk of developing avascular necrosis of the femoral head, and posttraumatic osteoarthritis is a common complication, even in the absence of associated fractures. Identification and timely management of hip dislocation are highly dependent on imaging, both at presentation and after attempted reduction. It is imperative for the radiologist to understand imaging features that guide management of hip dislocation to ensure timely identification, characterization, and communication of clinically relevant results. Although the importance of prompt identification of hip dislocation is universally recognized, the significance of imaging features that guide correct management and are thought to prevent complications is less emphasized in the radiology literature. In this article, the authors review the anatomy of the hip, common injury mechanisms for various types of dislocations, and imaging findings for associated injuries. They review the most commonly used classification systems and propose a simplified checklist approach to hip dislocation to aid rapid interpretation and communication of the most clinically relevant imaging features to the treating orthopedic surgeon. RSNA, 2017.

摘要

髋关节脱位是一种重要的骨科急症,通常发生在经历高能创伤的年轻患者中,常导致严重的长期发病率。快速识别和复位至关重要,因为长时间的脱位会增加股骨头缺血性坏死的风险,且创伤后骨关节炎是一种常见的并发症,即使没有相关骨折也是如此。髋关节脱位的识别和及时处理高度依赖于影像学检查,包括初次就诊时和复位后的影像学检查。放射科医生必须了解指导髋关节脱位处理的影像学特征,以确保及时识别、特征描述和沟通具有临床相关性的结果。尽管普遍认识到及时识别髋关节脱位的重要性,但在放射学文献中,指导正确处理和预防并发症的影像学特征的重要性却较少被强调。本文作者复习了髋关节的解剖结构、各种类型脱位的常见损伤机制以及相关损伤的影像学表现。他们还复习了最常用的分类系统,并提出了一种简化的髋关节脱位检查表方法,以帮助放射科医生快速解读和沟通最具临床相关性的影像学特征,从而为治疗骨科医生提供帮助。放射学会,2017 年。

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