Pradhan Chetan, Altaf Warid, Attarde Dheeraj, Sancheti Parag, Shyam Ashok
Department of Orthopaedic, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
Indian Orthopaedic Research Group, Thane, Maharashtra, India.
J Orthop Case Rep. 2023 Dec;13(12):7-10. doi: 10.13107/jocr.2023.v13.i12.4056.
Bilateral bifocal femur fractures occur as a result of high-velocity trauma mainly road traffic accidents with dashboard injuries or fall from height. These fractures can result in high morbidity or mortality as they are usually presented with hypovolemic shock or fatal fat embolism syndrome.
We present a 47-year-old male with a history of fall from 35 feet. He sustained a symmetrical intertrochanteric femur fracture with a diaphyseal femur fracture with a bilateral patella fracture. There was no evidence of any head injury or spinal fracture. The patient reached the emergency room in hypotension and was maintaining saturation on room air. The patient was admitted to the intensive care unit; hypotension was corrected overnight and was operated on after 24 h with bilateral intramedullary long proximal femoral nail and tension band wiring for the bilateral patella fractures. At 1-year follow-up, he was able to do his daily activities with minimal limitation.
Bilateral bifocal femur fractures result from a high-velocity trauma. In such injuries, careful evaluation of all the systems should be performed to find out concomitant injuries. Single-staged surgical intervention decreases the morbidities of the subsequent surgeries, helps in a rehabilitation hospital stay as well as financially suitable for the patient.
双侧双焦点股骨骨折主要由高速创伤导致,多为伴有仪表盘损伤的道路交通事故或高处坠落。这些骨折通常会引发低血容量性休克或致命性脂肪栓塞综合征,从而导致高发病率或死亡率。
我们报告一名47岁男性,有从35英尺高处坠落史。他遭受了双侧转子间股骨骨折、股骨干骨折以及双侧髌骨骨折。没有任何头部损伤或脊柱骨折的迹象。患者到达急诊室时处于低血压状态,在室内空气中维持血氧饱和度。患者被收入重症监护病房;低血压在夜间得到纠正,并在24小时后接受手术,采用双侧股骨近端髓内长钉固定以及双侧髌骨骨折张力带钢丝固定。在1年的随访中,他能够在极少限制的情况下进行日常活动。
双侧双焦点股骨骨折由高速创伤引起。对于此类损伤,应仔细评估所有系统以发现合并伤。一期手术干预可降低后续手术的发病率,有助于患者在康复医院的住院治疗,并且在经济上对患者也较为合适。