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双侧不对称创伤性髋关节脱位病例报告——一种罕见表现

A Case Report of Bilateral Asymmetrical Traumatic Hip Dislocation - A Rare Presentation.

作者信息

Nandi Ritwika, Das Pinaki, Nandi Sujit Narayan

机构信息

Department of Orthopaedics, Nil Ratan Sarkar Medical College and Hospital, 138 AJC Bose Road, Kolkata, West Bengal, India.

Department of Orthopaedics, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karni Memorial Hospital, 242 AJC Bose Road, Kolkata, West Bengal, India.

出版信息

J Orthop Case Rep. 2021 Aug;11(8):16-19. doi: 10.13107/jocr.2021.v11.i08.2346.

Abstract

INTRODUCTION

Asymmetric bilateral hip dislocations are very rarely reported in literature. We report a unique case of asymmetric traumatic bilateral hip dislocation in a 34-year-old male, describing the management and post-operative complications.

CASE REPORT

A 34-year-old truck driver sustained injury to both his hips in a head on collision between two trucks while seated in the passenger seat. There was a delay in presentation at our institution as he was referred after 17 h of the trauma. After evaluation, he underwent closed reduction of both hips under intravenous anesthesia on the same day. The post-reduction assessment revealed a left-sided posterior wall fracture which was suspected due to the instability after reduction. Fixation of the fracture was done using two spring plates. The patient was followed up throughout his rehabilitation and thereafter when he resumed his occupation. Six months after the incident, the patient had pain-free, full range of motion of both hips. Three years after the surgery radiological investigations revealed changes suggestive of early avascular necrosis (AVN), however, the patient did not have any functional restriction.

CONCLUSION

This is a case of bilateral asymmetric hip dislocation with left side posterior wall fracture. It is important to reduce the hip and also address the fracture as early as possible to prevent AVN.

摘要

引言

文献中极少报道不对称双侧髋关节脱位。我们报告一例34岁男性不对称创伤性双侧髋关节脱位的独特病例,描述其治疗及术后并发症。

病例报告

一名34岁的卡车司机坐在副驾驶座位上时,在两辆卡车的正面碰撞中双侧髋关节受伤。由于受伤17小时后才被转诊至我院,所以就诊延迟。经评估,他于同一天在静脉麻醉下接受了双侧髋关节闭合复位。复位后评估发现左侧后壁骨折,这是由于复位后不稳定而怀疑的。使用两块弹簧钢板对骨折进行固定。在患者整个康复过程以及之后恢复工作期间都进行了随访。事件发生六个月后,患者双髋关节无痛且活动范围正常。术后三年的影像学检查显示有早期股骨头缺血性坏死(AVN)的迹象,然而,患者没有任何功能受限。

结论

这是一例伴有左侧后壁骨折的双侧不对称髋关节脱位病例。尽早复位髋关节并处理骨折对于预防AVN很重要。

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