Jlidi Mohamed, Bouaicha Walid, Mallek Karim, Gharbi Mohamed Hedi, Jaziri Salma, Daas Selim
Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
SAGE Open Med Case Rep. 2024 Feb 25;12:2050313X241233199. doi: 10.1177/2050313X241233199. eCollection 2024.
Ipsilateral hip and knee dislocation is a rare and complex injury that usually results from high-energy trauma. Only 14 cases were reported in the literature so far. We report the case of a 35-year-old man who presented with an ipsilateral right hip and knee dislocation after being involved in a road traffic accident. A contralateral floating knee was associated. The hip dislocation was associated to a posterior wall fracture of the acetabulum and a femoral head fracture. The knee dislocation was compound and associated with a patella fracture. The hip dislocation was reduced. The posterior wall and the femoral head fractures were treated conservatively. The knee dislocation was reduced and stabilized by external fixator. Early postoperative infection occurred and was treated surgically. At the last follow-up, the knee was ankylosed at 5° of flexion with a bony bridge between the femoral condyle and the tibial plateau. The patient described an occasional hip pain on exertion. He had full range of motion of the right hip. No avascular necrosis of the femoral head was seen. Outcomes of simultaneous hip and knee dislocation are very variable and remain unpredictable. The timing of reducing the hip joint and the knee.
同侧髋膝关节脱位是一种罕见且复杂的损伤，通常由高能创伤导致。迄今为止，文献中仅报道了14例。我们报告一例35岁男性病例，该患者在道路交通事故后出现右侧同侧髋膝关节脱位。同时伴有对侧浮动膝损伤。髋关节脱位合并髋臼后壁骨折和股骨头骨折。膝关节脱位为开放性，合并髌骨骨折。髋关节脱位得以复位。髋臼后壁和股骨头骨折采用保守治疗。膝关节脱位通过外固定架复位并固定。术后早期发生感染，经手术治疗。在最后一次随访时，膝关节在屈曲5°时强直，股骨髁与胫骨平台之间形成骨桥。患者描述用力时偶尔会出现髋部疼痛。右髋关节活动范围正常。未见股骨头缺血性坏死。同时发生的髋膝关节脱位的预后差异很大，且仍然不可预测。髋关节和膝关节复位的时机。
