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不对称双侧创伤性髋关节脱位:一例报告。

Asymmetric bilateral traumatic hip dislocation: A case report.

作者信息

Alshammari Ahmed, Alanazi Basam, Almogbil Ismail, Alfayez Saud M

机构信息

Orthopedic Department, King Saud Medical City, Riyadh, Saudi Arabia.

Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Ann Med Surg (Lond). 2018 Jun 26;32:18-21. doi: 10.1016/j.amsu.2018.06.008. eCollection 2018 Aug.

Abstract

INTRODUCTION

Traumatic hip dislocation is a severe injury with the potential for significant morbidity and mortality. Bilateral hip dislocation is rare representing 1.25% of all hip dislocations.

PRESENTATION OF THE CASE

A 19-year-old male had a high-speed motor vehicle accident. After stabilizing the patient, it was noticed that the position of the right lower limb was in adduction and internal rotation while the left was in external rotation and abduction. Pelvis x-ray showed right superior posterior and left anterior inferior hip dislocations. Closed reduction was performed within 3 hours from the trauma for both sides. The post reduction CT scan showed adequate reduction of both hips with no associated fractures. During his three-year follow-up, he never had any complaints and the clinical examination and radiographs did not reveal any abnormalities.

DISCUSSION

Early reduction of hip dislocations minimizes the risk of osteonecrosis of the femoral head. The current recommendations state that a hip dislocation must be reduced within 6 hours.

CONCLUSION

This is a rare case of bilateral asymmetric hip dislocations with no concomitant fractures. It is important to reduce hip dislocation within 6 hours from the time of injury to prevent osteonecrosis of the femoral head.

摘要

引言

创伤性髋关节脱位是一种严重损伤,具有较高的发病和死亡风险。双侧髋关节脱位罕见,占所有髋关节脱位的1.25%。

病例介绍

一名19岁男性遭遇高速机动车事故。在使患者病情稳定后,发现右下肢处于内收和内旋位,而左下肢处于外旋和外展位。骨盆X光片显示右髋关节后上方脱位和左髋关节前下方脱位。在创伤后3小时内对双侧进行了闭合复位。复位后的CT扫描显示双侧髋关节复位良好,无相关骨折。在三年的随访期间,他从未有任何不适,临床检查和X光片均未发现任何异常。

讨论

髋关节脱位的早期复位可将股骨头缺血性坏死的风险降至最低。目前的建议是髋关节脱位必须在6小时内复位。

结论

这是一例罕见的双侧不对称髋关节脱位且无合并骨折的病例。受伤后6小时内对髋关节进行复位对于预防股骨头缺血性坏死很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d09f/6039880/43ceeca24991/gr1.jpg

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