Department of Orthopaedic Surgery, People's Hospital of Fengjie County, Chongqing, 404600, People's Republic of China.
Department of Orthopaedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China.
BMC Surg. 2020 Nov 11;20(1):278. doi: 10.1186/s12893-020-00941-2.
Total hip arthroplasty for Crowe type IV developmental dysplasia of the hip (DDH) is a complex procedure. Crowe type IV DDH combined with intertrochanteric frature is very rare.
A 75-year-old patient suffering from left hip pain after a fall was sent to our hospital. Plain radiographs and computed tomography scans were used to diagnose this patient with DDH combined with an intertrochanteric fracture. We conducted a total hip arthroplasty using an S-rom prosthesis following subtrochanteric shortening osteotomy in this patient, after which steel wires were used to fix the intertrochanteric fracture. The patient did not suffer any significant intraoperative or postoperative complications, and treatment was sufficient to overcome lower leg abnormalities. The patient was encouraged to resume walking with support at 3 days post-surgery, and at 6-month postoperatively he had regained the majority of his original range of motion. At 10-month postoperatively, the intertrochanteric fracture and subtrochanteric osteotomy of left femur had healed effectively,and the patient's VAS and mHSS scores had improved significantly.
Total hip arthroplasty is an effective approach to treat patients suffering from Crowe type IV DDH combined with an intertrochanteric fracture, and can achieve satisfactory clinical outcomes.
髋关节发育不良(DDH)克罗伊型 IV 型全髋关节置换术是一种复杂的手术。克罗伊型 IV 型 DDH 合并转子间骨折非常罕见。
一名 75 岁的老年患者,因跌倒后出现左髋部疼痛被送往我院。通过 X 线平片和 CT 扫描诊断该患者患有 DDH 合并转子间骨折。我们对该患者进行了全髋关节置换术,采用 S-ROM 假体,并进行了转子下缩短截骨术,随后使用钢线固定转子间骨折。患者未发生任何明显的术中或术后并发症,治疗足以克服下肢畸形。术后 3 天鼓励患者使用支撑物恢复行走,术后 6 个月,患者恢复了大部分原有的活动范围。术后 10 个月,左侧股骨转子间骨折和转子下截骨愈合良好,患者的 VAS 和 mHSS 评分显著改善。
全髋关节置换术是治疗克罗伊型 IV 型 DDH 合并转子间骨折的有效方法,可获得满意的临床效果。