Dotivala Sharukh, Coomber Ross, Chowdhry Majid, Carrothers Andrew D
Trauma & Orthopaedics, Addenbrookes Hospital, Cambridge, Cambridgeshire, UK.
BMJ Case Rep. 2018 Jan 23;2018:bcr-2017-222408. doi: 10.1136/bcr-2017-222408.
A 77-year-old man sustained an acetabular fracture after falling from a staircase and landing on his right side. He fractured the anterior column of his acetabulum and the quadrilateral plate. He underwent a single-stage open reduction and internal fixation of the fracture combined with a dual mobility total hip arthroplasty (THA). He sustained a traumatic hip dislocation 1 month postoperatively. Closed reduction was attempted at another hospital, and the femoral stem was pulled out. We believe this was caused by the polyliner being hitched either to the acetabular cup or in the soft tissues around the ilium. We present this case to caution orthopaedic surgeons that dual mobility THA dislocations are difficult to diagnose as the polyliner is not clearly seen on X-rays, and reduction attempts may lead to worsening of an already difficult situation.
一名77岁男性从楼梯上摔下，右侧着地后发生髋臼骨折。他的髋臼前柱和四边形板骨折。他接受了骨折的一期切开复位内固定术，并同时进行了双动全髋关节置换术（THA）。术后1个月，他发生了创伤性髋关节脱位。在另一家医院尝试进行闭合复位，结果股骨柄被拔出。我们认为这是由于聚乙烯内衬钩挂在髋臼杯或髂骨周围的软组织上所致。我们展示此病例是为了提醒骨科医生，双动全髋关节置换术脱位很难诊断，因为在X射线上看不到聚乙烯内衬，而且复位尝试可能会使本已困难的情况恶化。
