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一名患有骨质疏松症的老年女性左侧耻骨联合骨折合并同侧股骨颈未确诊骨折:病例报告

Left Pubic Symphysis Fracture With Undiagnosed Ipsilateral Femoral Neck Fracture in an Elderly Female With Osteoporosis: A Case Report.

作者信息

Delgadillo Blake E, DeFrancisis Jason S, Henwood Luke, Federico Justin R

机构信息

Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

Internal Medicine, Baptist Health, Jacksonville, USA.

出版信息

Cureus. 2024 Sep 11;16(9):e69203. doi: 10.7759/cureus.69203. eCollection 2024 Sep.

Abstract

Femoral neck fractures are a common complication of falls, particularly in the osteoporotic elderly female population. This case highlights the significance of properly radiologically evaluating elderly patients with falls. A 68-year-old White female with paroxysmal atrial fibrillation on anticoagulation, nicotine use disorder, chronic hyponatremia, hypertension, and hyperlipidemia presented to the emergency department (ED) in considerable pain four days after a previously diagnosed left pubic symphysis fracture. Repeat imaging (X-ray and computed tomography (CT)) was significant for a left femoral neck fracture concurrent with the aforementioned pelvic fracture. Within 48 hours of admission, the patient underwent a hemiarthroplasty of the left hip. The postoperative course was unremarkable, except for immensely decreased pain and a remarkable ability to ambulate, and on postoperative day three, the patient was discharged. In patients with an overall high risk of hip fracture, CT imaging should be considered after X-ray in an effort to eliminate the frequency of undiagnosed fractures. It is essential to thoroughly evaluate the entire film, even after one fracture is found. This is crucial to a patient's overall well-being and can contribute to many unwanted phenomena.

摘要

股骨颈骨折是跌倒的常见并发症,尤其在骨质疏松的老年女性人群中。本病例强调了对跌倒的老年患者进行适当的放射学评估的重要性。一名68岁的白人女性,患有阵发性心房颤动且正在接受抗凝治疗,有尼古丁使用障碍、慢性低钠血症、高血压和高脂血症,在先前诊断为左耻骨联合骨折四天后,因剧痛就诊于急诊科。再次影像学检查(X线和计算机断层扫描(CT))显示左股骨颈骨折与上述骨盆骨折并存。入院后48小时内,患者接受了左髋关节半关节置换术。术后过程顺利,疼痛大幅减轻,行走能力显著提高,术后第三天患者出院。在髋部骨折总体风险较高的患者中,应在X线检查后考虑进行CT成像,以减少未诊断骨折的发生率。即使发现一处骨折,也必须全面评估整个影像。这对患者的整体健康至关重要,否则可能导致许多不良情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d936/11390360/f0b294efcba2/cureus-0016-00000069203-i01.jpg

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