Dubey Siddharth, Azam Quamar, Sarkar Bhaskar, Agrahari Himanshu
Department of Trauma Surgery, AIIMS Rishikesh, Rishikesh, Uttarakhand, India.
J Orthop Case Rep. 2020 Nov;10(8):33-36. doi: 10.13107/jocr.2020.v10.i08.1848.
Concomitant ipsilateral floating hip with floating knee is a very rare injury pattern. Its co-occurrence with ipsilateral complete separation of ileum from pelvic girdle, which can be termed as "floating ileum," is even rarer. These are extremely high energy injuries associated with significant systemic insult adding to the dilemma and complexity in management. There is no mention in the literature about this potentially life-threatening injury combination; hence, an attempt has been made to provide a pathway of the management of this rare but complex injury pattern.
We are presenting a case of 17-year-old male with this menacing amalgamation of injuries along with the challenges associated in the management. The patient had ipsilateral complete disruption of sacroiliac joint along with transverse fracture of acetabulum due to which ileac bone was completely separated from rest of the pelvic bone and was displaced anteriorly, superiorly, and medially. The patient was also having ipsilateral shaft of femur fracture and distal third tibia fracture and acute respiratory distress syndrome as well to further complicate the scenario.
Early damage control, followed by definitive fixation and aggressive rehabilitation, appears to be the safe and acceptable path to reach good clinical outcome.
同侧浮动髋与浮动膝同时存在是一种非常罕见的损伤模式。它与同侧回肠从骨盆带完全分离（可称为“浮动回肠”）同时发生的情况更为罕见。这些都是极高能量的损伤，伴有严重的全身损伤，增加了治疗的困境和复杂性。文献中没有提及这种潜在危及生命的损伤组合；因此，本文试图提供一种处理这种罕见但复杂损伤模式的方法。
我们报告一例17岁男性患者，患有这种严重的复合损伤及其治疗中遇到的挑战。患者同侧骶髂关节完全脱位，髋臼横行骨折，导致髂骨与骨盆其余部分完全分离，并向前、上、内侧移位。患者还伴有同侧股骨干骨折和胫骨远端三分之一骨折以及急性呼吸窘迫综合征，使情况更加复杂。
早期损伤控制，随后进行确定性固定和积极康复，似乎是获得良好临床结果的安全且可接受的途径。
