Cambridge Orthopaedic Pelvic Unit (COPU), Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
University of Cambridge School of Clinical Medicine, Cambridge, UK.
Hip Int. 2024 Jan;34(1):122-133. doi: 10.1177/11207000231160075. Epub 2023 Mar 13.
A "floating hip" (FH) injury is a rare injury describing the simultaneous ipsilateral fracture of the femur and pelvis or acetabulum (P/A). We describe our experience with patients presenting with FH injuries and compare them to controls with similar P/A fractures but without femoral involvement.
Medical records and radiographs of FH patients and controls presenting to our tertiary centre between 2015 and 2020 were reviewed. Follow-up data from outpatient clinical records were also extracted. The control group were extensively matched by age, sex, body mass index, fracture classification and energy of injury.
From 1392 recorded P/A fractures, 42 FH cases were identified (average age 39 years, 78.6% males). The most common femoral fracture was the midshaft (35.7%), followed by the neck of femur (26.2%). 90.5% of FH injuries were due to high-energy mechanisms. 64.3% of P/A fractures, and 100% of femoral fractures were managed surgically. Compared to controls, FH cases were more likely to have additional orthopaedic injuries (73.8% vs. 40.5%, 0.002), more total theatre admissions (mean 2.5 vs. 1.19, 0.001), longer hospital stays (28.3 vs. 14.9 days, 0.02), and a higher rates of post-op complications (53.8% vs. 20%, 0.025).
We report differences in the presentation, management, and outcomes of FH injuries versus controls, even after extensive matching for confounders. These differences may inform future treatment strategies for the FH injury.
“浮动髋”（FH）损伤是一种罕见的损伤，描述的是同侧股骨和骨盆或髋臼（P/A）同时骨折。我们描述了我们在患有 FH 损伤的患者中的经验，并将其与具有相似 P/A 骨折但无股骨受累的对照组进行了比较。
回顾了 2015 年至 2020 年间在我们的三级中心就诊的 FH 患者和对照组的病历和 X 光片。还从门诊临床记录中提取了随访数据。对照组通过年龄、性别、体重指数、骨折分类和损伤能量进行了广泛匹配。
在记录的 1392 例 P/A 骨折中，发现 42 例 FH 病例（平均年龄 39 岁，78.6%为男性）。最常见的股骨骨折是中段（35.7%），其次是股骨颈（26.2%）。90.5%的 FH 损伤是由高能机制引起的。64.3%的 P/A 骨折和 100%的股骨骨折采用手术治疗。与对照组相比，FH 病例更有可能有其他骨科损伤（73.8%比 40.5%，0.002），更多的总手术室入院（平均 2.5 比 1.19，0.001），更长的住院时间（28.3 比 14.9 天，0.02），以及更高的术后并发症发生率（53.8%比 20%，0.025）。
即使在对混杂因素进行广泛匹配后，我们仍报告了 FH 损伤与对照组在表现、治疗和结果方面的差异。这些差异可能为 FH 损伤的未来治疗策略提供信息。
