Yang Yun, Peng Yin-Xiao, Yu Bin
Department of Orthopaedics, The Third People's Hospital of Chengdu, Sichuan, PR China.
EFORT Open Rev. 2024 Mar 5;9(3):150-159. doi: 10.1530/EOR-23-0013.
The aim of this study was to provide a comprehensive overview of floating hip injury and attempt to provide a management algorithm.
PubMed was searched using the terms 'Floating hip' or 'acetabular fracture' and 'Ipsilateral femoral fracture' or 'pelvic fracture' and 'Ipsilateral femoral fracture'. One author performed a preliminary review of the abstracts and references of the retrieved articles.
The mean injury severe score reported was higher than 20. Chest and abdominal injuries, as well as fractures at other sites, were the most common associated injuries. Despite the high disability rate, surgery remained the preferred option for managing these injuries. The surgical timing varied from a few hours to several days and was subjected to the principles of damage control orthopedics. Although, in most cases, fixation of femoral fractures took precedence over pelvic or acetabular fractures, there was still a need to consider the impact of damage control orthopedics, associated injuries, and surgeon's considerations and preferences. Posttraumatic arthritis, neurological deficits, heterotopic ossification, femoral head necrosis, femoral nonunion, and limb inequality were common complications of the floating hip injury.
The severity of such injuries often exceeds that of an isolated injury and often requires specialized multidisciplinary treatment. In the management of these complex cases, the complexity and severity of the injury should be fully assessed, and an appropriate surgical plan should be developed to perform definitive surgery as early as possible, with attention to prevention of complications during the perioperative period.
本研究旨在全面概述浮动髋损伤，并尝试提供一种治疗方案。
使用“浮动髋”或“髋臼骨折”以及“同侧股骨骨折”或“骨盆骨折”和“同侧股骨骨折”等术语在PubMed上进行检索。一位作者对检索到的文章的摘要和参考文献进行了初步审查。
报告的平均损伤严重程度评分高于20分。胸部和腹部损伤以及其他部位的骨折是最常见的合并损伤。尽管致残率很高，但手术仍然是治疗这些损伤的首选方案。手术时机从几小时到几天不等，并遵循损伤控制骨科的原则。虽然在大多数情况下，股骨骨折的固定优先于骨盆或髋臼骨折，但仍需要考虑损伤控制骨科、合并损伤以及外科医生的考虑因素和偏好的影响。创伤后关节炎、神经功能缺损、异位骨化、股骨头坏死、股骨不愈合和肢体不等长是浮动髋损伤的常见并发症。
此类损伤的严重程度通常超过单一损伤，往往需要专门的多学科治疗。在处理这些复杂病例时，应充分评估损伤的复杂性和严重程度，并制定适当的手术计划，尽早进行确定性手术，同时注意预防围手术期并发症。
