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[髋关节后脱位合并Pipkin骨折及坐骨神经损伤时髋臼后壁骨折的重建]

[Reconstruction of a fracture of the posterior acetabular wall with Pipkin fracture and lesion of the sciatic nerve after dorsal hip dislocation].

作者信息

Nolte Philip-Christian, Franke Jochen, Grützner Paul Alfred, Keil Holger

机构信息

Abteilung für Unfallchirurgie und Orthopädie, BG Klinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen am Rhein, Deutschland.

出版信息

Unfallchirurg. 2020 May;123(5):413-418. doi: 10.1007/s00113-020-00783-w.

Abstract

A 50-year-old male suffered a crash landing while paragliding and sustained a posterior dislocation of the hip with a Pipkin fracture type 4 (fracture of the posterior acetabular wall and Pipkin fracture type 2) and a lesion of the sciatic nerve. After primary treatment in an external hospital, the patient was transferred to this hospital 4 days following the trauma. An operative stabilization of the acetabular fracture and the Pipkin fracture was performed using a trochanter flip osteotomy. Despite a large central defect of the femoral head it was decided to attempt a reconstruction. Following fixation of the Pipkin fragment an autologous bone graft harvested from the intertrochanteric region was used to fill the defect. Subsequently, a collagen matrix was applied onto the filled defect and a perineural adaptation of the sciatic nerve was performed.

摘要

一名50岁男性在滑翔伞运动时遭遇迫降,导致髋关节后脱位,伴有4型皮金骨折(髋臼后壁骨折和2型皮金骨折)以及坐骨神经损伤。在外院接受初步治疗后,患者于受伤4天后转至本院。采用转子翻转截骨术对髋臼骨折和皮金骨折进行手术固定。尽管股骨头存在较大的中央缺损,但仍决定尝试进行重建。在固定皮金骨折块后,取自转子间区域的自体骨移植用于填充缺损。随后,将胶原基质应用于填充后的缺损处,并对坐骨神经进行神经外膜吻合。

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