Department of Orthopaedic Surgery, Emory University, Grady Memorial Hospital, Atlanta, Georgia.
JBJS Case Connect. 2022 Apr 13;12(2). doi: e22.00062. eCollection 2022 Apr 1.
A 45-year-old man appeared to have a central (protrusio) hip dislocation but actually had a transverse posterior wall acetabulum fracture with irreducible posterior dislocation due to impalement of the femoral head on the ischial spine. He underwent urgent open reduction on presentation and subsequent internal fixation in a staged manner. He developed avascular necrosis at 18 months postoperatively.
The nondisplaced ilioischial and iliopectineal acetabular radiographic lines were alerts that the dislocation was actually posterior. This led to further imaging before any closed reduction attempts because standard reduction maneuvers would have placed the patient at high risk for iatrogenic femoral head or neck fracture.
一名 45 岁男性表现为中心（前突）髋关节脱位，但实际上由于股骨头刺穿坐骨棘，发生横形后壁髋臼骨折伴不可复位的后脱位。他在出现时接受了紧急开放复位，随后分期进行了内固定。术后 18 个月时发生了股骨头缺血性坏死。
未移位的坐骨髂和坐骨耻骨髋臼线是提示脱位实际上为后脱位的线索。这导致在进行任何闭合复位尝试之前进行进一步的影像学检查，因为标准的复位手法会使患者面临医源性股骨头或颈骨折的高风险。
