Giannatos Vasileios, Antzoulas Panagiotis, Papathanidis Vasileios, Roumeliotis Anargyros, Stavropoulos Theodoros, Athanasiou Vasileios
University of Patras, Pátrai, Greece.
National and Kapodistrian University of Athens, Athens, Greece.
Eur J Orthop Surg Traumatol. 2025 May 9;35(1):182. doi: 10.1007/s00590-025-04299-0.
Anterior hip fracture-dislocation is a rare high energy injury with poor long-term prognosis. A Hill-Sachs-like hip fracture-dislocation is only scarcely described in the literature.
We report the case of a 57-year-old suffering an anterior hip fracture-dislocation after a self-inflicted collision with his motorcycle. Knee impaction on the ground with hip abduction and external rotation led to a Hill-Sachs type of lesion in the hip and anterior wall fracture of the acetabulum. Relocation of the hip was possible only under general anesthesia, and gross persistent instability was revealed after reduction. Poor post-operative outcomes by non-operative solutions or ORIF are widely described in the literature, and thus, we performed a total hip arthroplasty in the primary setting, with excellent post-operative outcome in 1-year follow-up and a forgotten joint.
In the rare occurrence of Hill-Sachs-like fracture-dislocation lesion of the hip, we recommend an operative solution in the primary setting, taking into consideration patient's age, intraoperative stability and defect's depth, with total hip arthroplasty being the mainstay of treatment.
髋关节前脱位骨折是一种罕见的高能量损伤，长期预后较差。文献中对类希尔-萨克斯型髋关节脱位骨折的描述很少。
我们报告一例57岁男性患者，在与摩托车发生自伤性碰撞后发生髋关节前脱位骨折。膝盖着地时髋关节外展和外旋导致髋关节出现希尔-萨克斯型损伤以及髋臼前壁骨折。仅在全身麻醉下才能进行髋关节复位，复位后发现明显的持续不稳定。文献中广泛描述了非手术治疗或切开复位内固定术后效果不佳的情况，因此，我们在初次治疗时进行了全髋关节置换术，术后1年随访效果良好，关节功能恢复理想。
在罕见的类希尔-萨克斯型髋关节脱位骨折损伤中，考虑到患者年龄、术中稳定性和缺损深度，我们建议在初次治疗时采用手术治疗，全髋关节置换术是主要治疗方法。
