Department of Orthopaedics, VPS Lakeshore Hospital, Kochi, India.
Deparment of Plastic Surgery, Aster Medcity, Kochi, India.
JBJS Case Connect. 2023 Aug 9;13(3). doi: 10.2106/JBJS.CC.23.00070. eCollection 2023 Jul 1.
We report a patient with intrapelvic prosthetic protrusion associated with infection after hemiarthroplasty for a fracture neck of the femur. We discuss the challenges involved in the management of this complex case with recommendations to manage a vascular injury.
In patients with an intrapelvic prosthesis, thorough preoperative vascular evaluation and vigilant postoperative check are required to prevent a vascular injury. In a suspected vessel injury after primary or revision total hip arthroplasty, it is imperative to get proximal control of the vessel before re-exploration. A combined arterial Doppler and computerized tomography angiogram is more reliable in picking up arterial impingement by acetabular screws.
我们报告了一例股骨颈骨折半髋关节置换术后感染导致盆腔内假体突出的患者。我们讨论了管理这种复杂病例所涉及的挑战,并提出了管理血管损伤的建议。
对于盆腔内有假体的患者,需要进行彻底的术前血管评估和术后密切检查,以防止血管损伤。对于初次或翻修全髋关节置换术后疑似血管损伤的患者,在再次探查前必须对血管进行近端控制。动脉多普勒和计算机断层血管造影联合应用更能可靠地发现髋臼螺钉对动脉的压迫。