Peters Jan, Köhler Hans-Christian, Gutcke André, Schulze Christoph
Klinik für Orthopädie und Unfallchirurgie, Plastische, Rekonstruktive und Handchirurgie, Bundeswehrkrankenhaus Westerstede, Lange Straße 38, 26655, Westerstede, Deutschland.
Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057, Rostock, Deutschland.
Unfallchirurgie (Heidelb). 2023 Nov;126(11):904-908. doi: 10.1007/s00113-023-01307-y. Epub 2023 Mar 13.
A 78-year-old female patient sustained a left-sided proximal femoral fracture due to a fall. Since childhood the patient had suffered from ankylosis of unknown origin in the ipsilateral hip joint. The recommended intramedullary osteosynthesis could restore the original status quo before the fracture. It needs less time in the operating room (OR) and includes a lower risk for intraoperative complications than a hip joint endoprosthesis. Arthroplasty can lead to a significant improvement in mobility of the hip joint but requires more time in the OR for the surgical procedure and anesthesia time and includes a higher risk for intraoperative and postoperative complications. The antetorsion angle of 76° in this patient deviated extremely from the standard and made the intramedullary osteosynthesis for this type of fracture a challenge. Using improvised techniques led to a load-stable fracture treatment that ultimately led to a satisfactory result.
一名78岁女性患者因跌倒导致左侧股骨近端骨折。自童年起，该患者同侧髋关节就患有不明原因的关节强硬。推荐的髓内骨固定术可以恢复骨折前的原状。与髋关节置换术相比，它在手术室的时间更短，术中并发症风险更低。关节成形术可显著改善髋关节活动度，但手术过程和麻醉时间在手术室需要更多时间，且术中及术后并发症风险更高。该患者76°的前倾角与标准值偏差极大，使得这种类型骨折的髓内骨固定术成为一项挑战。采用临时技术实现了负荷稳定的骨折治疗，最终取得了满意的结果。
