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创伤后髋关节前脱位合并同侧粗隆间粉碎性骨折:1例罕见病例报告

Posttraumatic Anterior Hip Dislocation with Ipsilateral Comminuted Intertrochanteric Fracture: A Rare Case Report.

作者信息

Prabhat Vinay, Prasad Verma Dipak Kumar Prakash, Topno Rohit, Kundu Sabyasachi

机构信息

Department of Orthopedics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

出版信息

Ann Afr Med. 2024 Oct 1;23(4):748-751. doi: 10.4103/aam.aam_62_24. Epub 2024 Aug 13.

Abstract

Hip joint is a ball and socket type of joint and its anatomic features makes it very stable. However, Incidence of hip dislocation has increased recently due to high energy trauma like road traffic accident, fall from height etc. It is usually associated with fracture of femoral head, neck, shaft and acetabular wall. Association of ipsilateral intertrochantric fracture is exceedingly rare and only a few case reports are available in the literature. We are presenting a rare case report of neglected anterior hip dislocation with ipsilateral comminuted intertrochanteric fracture managed with hemiarthroplasty using long cemented distal press-fit revision stem. A 66-year-old male presented to our outpatient department with history of fall from a tree 22 days back with pain in right hip and inability to bear weight on right lower limb. Radiographs were suggestive of anterior hip dislocation with fracture of ipsilateral comminuted intertrochanteric fracture of right side. Anterior hip dislocation with ipsilateral intertrochanteric fracture is a very rare entity, and only a few case reports are available in the literature. Management includes early open reduction and fixation to achieve optimal outcomes, but doing primary arthroplasty is also a viable option especially in neglected cases as there is high chances of avascular necrosis and secondary osteoarthritis of the hip joint later on.

摘要

髋关节是球窝关节,其解剖结构使其非常稳定。然而,近年来,由于道路交通事故、高处坠落等高能量创伤,髋关节脱位的发生率有所增加。它通常与股骨头、颈、骨干和髋臼壁骨折相关。同侧转子间骨折的关联极为罕见,文献中仅有少数病例报告。我们报告一例罕见的被忽视的前髋关节脱位合并同侧粉碎性转子间骨折的病例,采用长柄骨水泥远端压配翻修柄进行半髋关节置换术治疗。一名66岁男性因22天前从树上跌落,右髋疼痛且右下肢无法负重前来我院门诊就诊。X线片提示右侧前髋关节脱位合并同侧粉碎性转子间骨折。前髋关节脱位合并同侧转子间骨折是一种非常罕见的情况,文献中仅有少数病例报告。治疗包括早期切开复位内固定以获得最佳疗效,但一期关节置换术也是一种可行的选择,尤其是在被忽视的病例中,因为后期髋关节发生缺血性坏死和继发性骨关节炎的可能性很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6f/11556492/82b9b056d2a0/AAM-23-748-g001.jpg

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