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股骨近端囊内骨折在双侧膝上截肢患者中的病例报告:术中定位技术要点及文献复习。

Intracapsular fracture of the proximal femur in a bilateral above-knee amputee: A case report with technical tips for intraoperative positioning and literature review.

机构信息

Primus Super Specialty Hospital, New Delhi, India.

Department of Orthopaedics, Jay Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Chin J Traumatol. 2022 Sep;25(5):306-310. doi: 10.1016/j.cjtee.2021.09.003. Epub 2021 Sep 14.

Abstract

Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.

摘要

股骨近端囊内骨折是下肢最常见的骨折之一。大多数情况下需要使用合适的植入物进行骨内固定,术中将患者置于骨折台上的定位是便于骨折操作、牵引、复位和透视评估的前提。然而,对于双侧膝关节以上截肢患者相关股骨近端骨折的内固定,定位肢体是一项困难的任务,这需要定制库存以有效定位肢体和进行骨折操作。本研究报告了一例罕见的道路交通伤导致双侧下肢挤压伤的病例,并描述了双侧膝关节以上截肢急性股骨颈骨折的一些技术要点。患者行急症切断术,随后二期闭合伤口,随后采用多孔空心加压螺钉对右侧股骨颈骨折进行内固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8329/9459004/f382e28c9a9c/gr1.jpg

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