Selvanayagam Rajkumar, Tiwari Vivek, Das Saubhik, Trikha Vivek
Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND.
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2018 Sep 11;10(9):e3287. doi: 10.7759/cureus.3287.
Due to the inherent stability of the hip joint, hip dislocations constitute a relatively small proportion of all the traumatic dislocations encountered in the emergency department. Among them, the anterior type of hip dislocation is less common than the posterior type of dislocation. Anterior dislocations are usually associated with an injury to other, nearby structures like the acetabulum and femoral head. An ipsilateral greater trochanter fracture with anterior hip dislocation is very sparsely reported in the literature. We report the case of a pubic type of anterior hip dislocation associated with a concomitant ipsilateral greater trochanter fracture. The joint was reduced promptly with traction-countertraction under sedation, and the associated fracture was subsequently fixed with two 6.5 mm partially threaded, cannulated, cancellous screws. The patient was symptom-free at the last follow-up of one year with a full range of hip joint motion, and without any evidence of osteonecrosis or osteoarthritis. The mechanism of greater trochanter fracture in such injuries and its management has been discussed.
由于髋关节具有固有的稳定性,髋关节脱位在急诊科遇到的所有创伤性脱位中所占比例相对较小。其中,髋关节前脱位比后脱位少见。前脱位通常与髋臼和股骨头等附近其他结构的损伤相关。文献中关于同侧大转子骨折合并髋关节前脱位的报道非常稀少。我们报告一例耻骨型髋关节前脱位合并同侧大转子骨折的病例。在镇静下通过牵引-对抗牵引迅速复位关节,随后用两枚6.5毫米半螺纹空心松质骨螺钉固定相关骨折。在最后一年的随访中,患者无症状,髋关节活动范围正常,且无任何骨坏死或骨关节炎迹象。本文讨论了此类损伤中大转子骨折的机制及其处理方法。