Nakai Takuya, Fukunishi Shigeo
Orthopedic Surgery, Nishinomiya Kaisei Hospital, Nishinomiya, JPN.
Cureus. 2025 Jun 15;17(6):e86065. doi: 10.7759/cureus.86065. eCollection 2025 Jun.
Fragility fractures of the pelvis (FFP) in the elderly have been on the rise. Conventional treatment options have often been conservative. However, in recent years, osteosynthesis has been recommended in order to achieve early ambulation. Surgical treatment was performed for combined FFP, femoral neck and acetabular fractures in elderly patients who did not have a clear history of trauma. In this case report, we describe two cases of combined fractures of FFP. Patient 1 was diagnosed with a combined fracture of the femoral neck and acetabulum, classified according to Rommens classification as III-c, and following osteosynthesis for a posterior column fracture, underwent allogenic bone grafting and total hip arthroplasty (THA) with a Burch-Schneider cage. Patient 2 was diagnosed with a combined fracture of the femoral neck and acetabulum, classified according to Rommens classification as II-b. The patient underwent THA with an allogenic bone graft and a Kerboull-type plate. Surgical treatment with THA using an acetabular reinforcement device has been successful in rare cases with combined fractures of the FFP, femoral neck and acetabulum.
老年骨盆脆性骨折(FFP)的发生率一直在上升。传统的治疗方法通常较为保守。然而,近年来,为了实现早期行走,推荐采用骨固定术。对于没有明确外伤史的老年患者的FFP合并股骨颈和髋臼骨折,进行了手术治疗。在本病例报告中,我们描述了两例FFP合并骨折的病例。患者1被诊断为股骨颈和髋臼联合骨折,根据Rommens分类为III - c型,在对后柱骨折进行骨固定术后,接受了异体骨移植和使用Burch - Schneider笼的全髋关节置换术(THA)。患者2被诊断为股骨颈和髋臼联合骨折,根据Rommens分类为II - b型。该患者接受了异体骨移植和Kerboull型钢板的THA。在极少数FFP、股骨颈和髋臼联合骨折的病例中,使用髋臼强化装置进行THA的手术治疗取得了成功。