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两名同侧下肢截肢患者股骨颈骨折的骨固定术。

Osteosynthesis in femoral neck fracture in two patients with ipsilateral lower limb amputation.

作者信息

Singh Deepak, Dhammi Ish Kumar, Jain Archit, Shahi Pratyush, Kumar Saurabh, Bansal Kuldeep

机构信息

Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India.

Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India

出版信息

BMJ Case Rep. 2021 Mar 25;14(3):e239060. doi: 10.1136/bcr-2020-239060.

Abstract

Femoral neck fracture in lower limb amputees poses treatment problems. The altered biomechanics of the hip in amputees, stump length, associated osteoporosis and difficulty in positioning these patients on the operation table are few of the technical challenges faced by an operating surgeon especially while salvaging the native hip joint. We report a case series of two lower limb amputee patients with fracture neck of femur in whom we salvaged the native hip joint by performing osteosynthesis. We observed satisfactory results of osteosynthesis in both of our patients on follow-up, with both achieving pretrauma ambulatory status in 6-8 weeks postoperatively. We concluded that each lower limb amputee patient with fracture neck of femur should be carefully evaluated on presentation and managed individually. These patients can be positioned and managed by osteosynthesis on a standard operating table or fracture table without requiring any special operating theatre set-up (traction devices).

摘要

下肢截肢者的股骨颈骨折带来了治疗难题。截肢者髋关节生物力学的改变、残肢长度、相关的骨质疏松以及将这些患者安置在手术台上的困难,是手术外科医生面临的一些技术挑战,尤其是在挽救天然髋关节时。我们报告了一系列两例下肢截肢且股骨颈骨折的患者,我们通过骨接合术挽救了他们的天然髋关节。随访时,我们观察到两名患者的骨接合术均取得了满意的效果,两人在术后6 - 8周均恢复到创伤前的行走状态。我们得出结论,每例下肢截肢且股骨颈骨折的患者在就诊时都应仔细评估并进行个体化治疗。这些患者可以在标准手术台或骨折台上通过骨接合术进行安置和治疗,无需任何特殊的手术室设置(牵引装置)。

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本文引用的文献

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Stress fractures of the femoral neck in runners: a review.跑步者股骨颈的应力性骨折:综述。
Res Sports Med. 2016 Jul-Sep;24(3):185-99. doi: 10.1080/15438627.2016.1191489. Epub 2016 Jun 6.
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Treatment of neglected femoral neck fracture.陈旧性股骨颈骨折的治疗。
Indian J Orthop. 2015 Jan-Feb;49(1):17-27. doi: 10.4103/0019-5413.143909.

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