Rizkallah Maroun, Haddad Marwan, Haykal Gaby
Orthopedic Surgery Department, Mount Lebanon Hospital, Faculty of Medicine, Saint Joseph University, Blvd. Camille Chamoun, Beirut, Lebanon.
Radiology Department, Mount Lebanon Hospital, Faculty of Medicine, Lebanese University, Blvd. Camille Chamoun, Beirut, Lebanon.
J Hip Preserv Surg. 2019 Mar 1;6(1):86-90. doi: 10.1093/jhps/hnz006. eCollection 2019 Jan.
Femoral head fractures in adults are known to be frequently associated with femoral neck fractures, acetabular fractures and sciatic nerve neurapraxia. Here, we report for the first time in the English medical literature the case of a 30-year-old patient having a Pipkin Type II comminuted femoral head fracture associated to an isolated acetabular labral osteochondral avulsion. This entity was diagnosed preoperatively through the presence of the acetabular 'fleck' sign recently described in adolescents with hip dislocation. This was of paramount importance knowing the key role of the acetabular labrum in physiological hip functioning. Therefore, a high index of suspicion of complete posterior acetabular labrum avulsion should be raised in front of a hip computed tomography scan showing the acetabular fleck sign even in an adult patient. This finding is important in posing the surgical indication and in completing the preoperative surgical planning in cases of femoral head fractures and dislocations.
成人股骨头骨折常与股骨颈骨折、髋臼骨折及坐骨神经挫伤相关。在此，我们首次在英文医学文献中报道了一例30岁患者，其患有皮普金II型粉碎性股骨头骨折，同时伴有孤立的髋臼盂唇骨软骨撕脱。该病例术前通过髋臼“斑点”征得以诊断，此征最近在青少年髋关节脱位中被描述。鉴于髋臼盂唇在髋关节生理功能中的关键作用，这一点至关重要。因此，即使在成年患者中，当髋关节计算机断层扫描显示髋臼斑点征时，也应高度怀疑髋臼后盂唇完全撕脱。这一发现对于确定手术指征以及完善股骨头骨折和脱位病例的术前手术规划具有重要意义。
