Ceri Lorenzo, Zanna Luigi, Buzzi Roberto, De Biase Pietro
Traumatology and General Orthopaedic Unit, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
Trauma Case Rep. 2021 Mar 11;32:100451. doi: 10.1016/j.tcr.2021.100451. eCollection 2021 Apr.
Traumatic hip dislocations typically result of high-energy trauma and frequently involve young patients. The obturator dislocation is not a common condition and rarely combined with acetabular fracture. We report a rare case of a 48-year-old male patient with a trauma of the left hip following a car-vs-car frontal accident. He presented with an obturator hip dislocation combined with ipsilateral quadrilateral plate fracture. The patient underwent a clinical and imaging evaluation to identify the acetabular fracture dislocation. The CT scan showed a severe dislocation of the acetabular medial wall. conscious was performed in Emergency Department. The patient underwent open reduction and internal fixation. During surgery, obturator nerve was entrapped inside the fracture rim and then it was released. No intra-operative complications were observed. The patient was followed, with accurate clinical and radiological follow up assessments for 24 months reporting excellent clinical outcomes according to Oxford Hip Score (47/48 points), a good hip range of motion and a complete recovery of basic activities of daily living. After two years of follow-up, no evidence of femoral head necrosis was reported and the patient returned to sport activity.
创伤性髋关节脱位通常由高能量创伤导致，且常累及年轻患者。闭孔脱位并不常见，很少合并髋臼骨折。我们报告一例罕见病例，一名48岁男性患者在轿车与轿车正面碰撞事故后出现左髋部创伤。他表现为闭孔髋关节脱位合并同侧四边形板骨折。患者接受了临床和影像学评估以确定髋臼骨折脱位情况。CT扫描显示髋臼内壁严重脱位。在急诊科进行了清醒处理。患者接受了切开复位内固定术。手术过程中，闭孔神经被困于骨折边缘内，随后被松解。未观察到术中并发症。对患者进行了随访，进行了准确的临床和放射学随访评估，为期24个月，根据牛津髋关节评分（47/48分）报告临床结果极佳，髋关节活动范围良好，基本日常生活活动完全恢复。随访两年后，未报告股骨头坏死迹象，患者恢复了体育活动。
