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妊娠期间双侧缺血性坏死导致髋部骨折:一例报告。

Bilateral avascular necrosis leading to hip fracture in pregnancy: A case report.

作者信息

Mencia Marlon M, Cruz Pedro Pablo Hernandez, Bidaisee Shanta, Beharry Allan

机构信息

Department of Clinical Surgical Sciences, The University of the West Indies, Trinidad and Tobago.

Department of Surgery, Port-of-Spain General Hospital, Port of Spain, Trinidad and Tobago.

出版信息

Case Rep Womens Health. 2024 Dec 11;45:e00675. doi: 10.1016/j.crwh.2024.e00675. eCollection 2025 Mar.

Abstract

Avascular necrosis (AVN) of the hip, a rare cause of pelvic pain in the third trimester of pregnancy, often presents with nonspecific symptoms that resemble common musculoskeletal conditions. This ambiguity, coupled with concerns about the safety of magnetic resonance imaging (MRI) during pregnancy, can hinder timely diagnosis. We report a unique case of a 32-year-old primigravida diagnosed with a hip fracture and bilateral AVN of the femoral head in the immediate postpartum period, a complication seemingly not previously documented in pregnant patients. The initial management involved closed reduction and internal fixation using cannulated screws. However, progressive femoral head collapse necessitated revision to a total hip arthroplasty. This case underscores the importance of early diagnosis and recognition of AVN in pregnancy to prevent severe complications. It highlights the diagnostic challenges and emphasizes the need for heightened awareness and earlier imaging investigations in similar clinical scenarios.

摘要

髋部缺血性坏死(AVN)是妊娠晚期骨盆疼痛的罕见原因,通常表现为与常见肌肉骨骼疾病相似的非特异性症状。这种模糊性,再加上对孕期磁共振成像(MRI)安全性的担忧,可能会阻碍及时诊断。我们报告了一例独特病例,一名32岁初产妇在产后立即被诊断为髋部骨折和双侧股骨头AVN,这一并发症似乎此前在妊娠患者中未被记录。初始治疗包括使用空心螺钉进行闭合复位和内固定。然而,股骨头逐渐塌陷使得必须翻修为全髋关节置换术。该病例强调了孕期早期诊断和识别AVN以预防严重并发症的重要性。它突出了诊断挑战,并强调在类似临床情况下需要提高认识并尽早进行影像学检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5d8/11700261/31f51eb8ea13/gr1.jpg

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