Zhou Xiaofeng, Liu Yu, Zhang Ajuan, Wang Chenglong, Zhao Xuehui, Dong Jinlei, Liu Fanxiao, Xu Weicheng, Feng Fan, Li Lianxin, Lu Shun
Department of Orthopaedics Surgery, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.
Department of Orthopedics, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.
BMC Musculoskelet Disord. 2024 Dec 3;25(1):988. doi: 10.1186/s12891-024-08105-6.
Floating hip is a severe high-energy injury. Femoral fracture is an essential component of floating hip. However, few studies have addressed the relationship between the femoral fracture pattern and floating hip injury. In this study, we reviewed and summarized the epidemiological and clinical data of patients with floating hip.
We retrospectively reviewed patients with a diagnosis of floating hip at our trauma center from January 2014 to December 2021. Data on patient demographics, characteristics of the injuries, associated injuries, whether sciatic nerve palsy (SNP) occurred, the number of operations performed, and the total length of hospital stay were analyzed.
A total of 76 patients met the diagnostic criteria for floating hip, 45 of whom had proximal femoral fractures. The mean Injury Severity Scores in patients with proximal and non-proximal femoral fractures were 21.47 ± 10.67 and 17.61 ± 7.64, respectively, and the mean Abbreviated Injury Scale scores were 13.31 ± 9.71 and 9.52 ± 4.32, respectively. Motor vehicle collision and a fall from a height were the main causes of injury. Chest injury was the most common associated injury. Twenty-two patients were diagnosed with SNP, 17 of whom had a proximal femoral fracture. Of the patients with pelvic fractures, 15 were diagnosed with SNP, 14 of whom also had a proximal femoral fracture. Of the patients with acetabular fractures, seven were diagnosed with SNP, three of whom also had a proximal femoral fracture.
More than half of patients with floating hips have a combined proximal femoral fracture. In this study, fracture of the pelvis or acetabulum combined with a proximal femoral fracture had a higher AIS score and higher risk of SNP than fracture of the pelvis or acetabulum combined with a non-proximal femoral fracture. Patients with a single pelvic fracture showed similar results, but patients with a single acetabular fracture did not. A pelvic or acetabular fracture combined with a proximal femoral fracture has a different outcome than a mid-distal femoral fracture, which may be a "true" floating hip.
浮动髋是一种严重的高能损伤。股骨骨折是浮动髋的重要组成部分。然而，很少有研究探讨股骨骨折类型与浮动髋损伤之间的关系。在本研究中，我们回顾并总结了浮动髋患者的流行病学和临床数据。
我们回顾性分析了2014年1月至2021年12月在我院创伤中心诊断为浮动髋的患者。分析了患者的人口统计学数据、损伤特征、合并损伤、是否发生坐骨神经麻痹（SNP）、手术次数及住院总时长。
共有76例患者符合浮动髋诊断标准，其中45例合并股骨近端骨折。股骨近端骨折和非近端骨折患者的平均损伤严重程度评分分别为21.47±10.67和17.61±7.64，平均简明损伤定级评分分别为13.31±9.71和9.52±4.32。机动车碰撞和高处坠落是主要致伤原因。胸部损伤是最常见的合并损伤。22例患者被诊断为SNP，其中17例合并股骨近端骨折。在骨盆骨折患者中，15例被诊断为SNP，其中14例也合并股骨近端骨折。在髋臼骨折患者中，7例被诊断为SNP，其中3例也合并股骨近端骨折。
超过半数的浮动髋患者合并股骨近端骨折。在本研究中，骨盆或髋臼骨折合并股骨近端骨折比骨盆或髋臼骨折合并非近端股骨骨折的简明损伤定级评分更高，发生SNP的风险也更高。单纯骨盆骨折患者结果相似，但单纯髋臼骨折患者并非如此。骨盆或髋臼骨折合并股骨近端骨折与股骨中远端骨折的预后不同，后者可能是“真正的”浮动髋。
