Li Lin, Li Lianxin, Zhou Dongsheng, Zhao Qin, Li Ci
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Rehabilitation Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Front Surg. 2025 Mar 11;12:1510344. doi: 10.3389/fsurg.2025.1510344. eCollection 2025.
To explore the clinical characteristics and treatment strategies of the hip fracture triad (acetabular fracture, hip dislocation combined with proximal femur fracture).
A retrospective analysis was performed on 11 patients with hip fracture triad admitted to Shandong Provincial Hospital from January 2014 to December 2020. There were 9 males and 2 females; age (38.7 ± 12.2) years old (range 12-53 years). After all patients are admitted to the hospital, a treatment plan will be formulated based on the fracture type and associated injuries, and long-term follow-up will be conducted.
This study included clinical data of 11 patients with hip fracture triad, of which 9 cases were treated surgically and 2 cases were treated conservatively. All patients were followed up. 9 patients successfully completed the operation. The operation time was (4.4 ± 1.4) hours (range 3-8 h); intraoperative bleeding was (600.0 ± 355.9) ml (range 400-1,200 ml). Fracture reduction was evaluated according to the acetabular fracture Matta score: 7 cases were excellent, 2 was good, and none was poor; 2 patients with old injuries chose conservative treatment as the final treatment plan. Acetabular fractures at the final follow-up were evaluated using the modified Merle d'Aubigné-Postel score of the hip joint: 7 cases were excellent, 1 was good, and 3 were poor. 1 patient developed traumatic hip arthritis after surgery, underwent total hip arthroplasty, and recovered well after surgery; 1 patient underwent hemihip arthroplasty 1 year after surgery due to femoral neck fracture and recovered well after surgery; 1 patient suffered from cerebral infarction complicated by long-term bed rest, poor hip joint mobility and basic loss of self-care ability; 2 patients with conservative treatment of old fracture had limited hip joint functional mobility, unequal length of both lower limbs, and poor hip joint mobility.
The hip fracture triad is a complex, high-energy injury that is extremely rare clinically. A correct understanding of the characteristics and mechanism of this type of injury, and prompt and effective treatment strategies, will help improve patient prognosis. Surgery is the preferred treatment option for this injury, and early reduction or lower limb traction can help reduce the occurrence of postoperative complications.
探讨髋部骨折三联征（髋臼骨折、髋关节脱位合并股骨近端骨折）的临床特点及治疗策略。
对2014年1月至2020年12月山东省立医院收治的11例髋部骨折三联征患者进行回顾性分析。其中男性9例，女性2例；年龄（38.7±12.2）岁（范围12 - 53岁）。所有患者入院后，根据骨折类型及合并损伤制定治疗方案，并进行长期随访。
本研究纳入11例髋部骨折三联征患者的临床资料，其中9例行手术治疗，2例行保守治疗。所有患者均获随访。9例患者手术成功完成。手术时间为（4.4±1.4）小时（范围3 - 8小时）；术中出血量为（600.0±355.9）毫升（范围400 - 1200毫升）。根据髋臼骨折Matta评分评估骨折复位情况：优7例，良2例，差0例；2例陈旧伤患者选择保守治疗作为最终治疗方案。末次随访时采用髋关节改良Merle d'Aubigné - Postel评分评估髋臼骨折情况：优7例，良1例，差3例。1例患者术后发生创伤性髋关节炎，行全髋关节置换术，术后恢复良好；1例患者术后1年因股骨颈骨折行半髋关节置换术，术后恢复良好；1例患者因长期卧床并发脑梗死，髋关节活动度差，基本丧失自理能力；2例陈旧骨折保守治疗患者髋关节功能活动受限，双下肢不等长，髋关节活动度差。
髋部骨折三联征是一种复杂的高能量损伤，临床极为罕见。正确认识此类损伤的特点及机制，并采取及时有效的治疗策略，有助于改善患者预后。手术是该损伤的首选治疗方式，早期复位或下肢牵引有助于减少术后并发症的发生。
