Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Los Angeles, California.
Department of Orthopaedic Surgery, KU-Wichita, Wichita, Kansas.
JBJS Case Connect. 2020 Dec 24;10(4):e20.00104. doi: 10.2106/JBJS.CC.20.00104.
We describe a case of posterior hip dislocation in a 13-year-old boy after a contact football injury with attempted closed reduction resulting in complete separation of the epiphysis from the femoral neck metaphysis with associated femoral head fracture and posterior dislocation of the femoral head. Treatment was emergently performed with a greater trochanteric osteotomy, open reduction internal fixation using cannulated screws, and additional small diameter drill holes in the femoral head to promote blood flow. The patient did well postoperatively and at over 4 years follow-up had no evidence of avascular necrosis and returned to full athletics participation.
Particular attention should be taken when reducing hip dislocations in the adolescent population who may be predisposed to epiphysiolysis. Preservation of periosteal soft-tissue attachments and the use of small diameter drill holes to promote femoral head blood flow may have contributed to the excellent outcome.
我们描述了一例 13 岁男孩在接触性橄榄球受伤后发生的髋关节后脱位。尝试闭合复位后，导致骺从股骨颈干骺端完全分离，伴有股骨头骨折和股骨头后脱位。紧急采用大转子截骨术、空心螺钉切开复位内固定术和股骨头内的额外小直径钻孔以促进血流进行治疗。术后患者情况良好，随访超过 4 年，无股骨头坏死证据，并恢复了全面的运动参与。
在青少年人群中，当髋关节脱位时应特别注意，他们可能容易发生骺离骨折。保留骨膜软组织附着和使用小直径钻孔以促进股骨头血流可能有助于取得良好的结果。
