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髋关节脱位合并同侧股骨干骨折:一例罕见病例报告。

Hip dislocation with ipsilateral shaft of femur fracture: A rare case report.

作者信息

Singh Ratish, Mishra Amit Ranjan, Yadav Hem Shankar, Yadav Hridhika

机构信息

Janaki Medical College and Teaching Hospital, Nepal.

Janaki Medical College and Teaching Hospital, Nepal.

出版信息

Int J Surg Case Rep. 2025 Sep;134:111674. doi: 10.1016/j.ijscr.2025.111674. Epub 2025 Jul 16.

Abstract

INTRODUCTION

Posterior hip dislocation with ipsilateral shaft of femur fracture is a very rare case encountered. This case presents a rare combination of posterior hip dislocation with ipsilateral femoral shaft fracture with head of femur fracture of a sixteen year old male patient following a road traffic accident (RTA). It emphasizes the importance of a multidisciplinary trauma protocol, early imaging, and timely surgical intervention in complex orthopedic injuries.

CASE PRESENTATION

Patient was presented in the emergency department with complaints of severe pain and deformity in the left hip and thigh, inability to bear weight, and laceration below the left knee. After initial emergency management patient was operated on with closed reduction of the hip and intramedullary interlocking nailing of the femur after 6 h. Postoperatively, skin traction was applied for 2 weeks to prevent re-dislocation of the hip. Successful surgical management with good functional recovery was achieved. At 2 weeks, the patient was ambulatory with non-weight bearing and crutch walking with no complications seen.

CLINICAL DISCUSSION

This case underscores the need for protocol-driven, multidisciplinary care in adolescent trauma, with emphasis on early intervention and comprehensive assessment for preventing the patient from complications such as avascular necrosis of the femoral head.

CONCLUSION

Posterior dislocation of the hip with ipsilateral shaft of femur fracture is an uncommon type of injury where early emergency management followed by prompt surgical intervention is required to prevent avascular necrosis of the femur head. Regular follow-up is essential for monitoring and assessment of condition of hip.

摘要

引言

髋关节后脱位合并同侧股骨干骨折是一种非常罕见的病例。本病例呈现了一名16岁男性患者在道路交通事故(RTA)后出现的罕见组合,即髋关节后脱位合并同侧股骨干骨折及股骨头骨折。它强调了多学科创伤治疗方案、早期影像学检查以及对复杂骨科损伤进行及时手术干预的重要性。

病例介绍

患者因左髋部和大腿严重疼痛、畸形、无法负重以及左膝下方撕裂伤被送至急诊科。经过初步急救处理后,患者在6小时后接受了髋关节闭合复位及股骨髓内交锁髓内钉固定手术。术后,进行了2周的皮肤牵引以防止髋关节再次脱位。手术治疗成功,功能恢复良好。术后2周,患者可借助拐杖非负重行走,未出现并发症。

临床讨论

本病例强调了在青少年创伤中需要遵循方案驱动的多学科护理,重点是早期干预和全面评估,以防止患者出现诸如股骨头缺血性坏死等并发症。

结论

髋关节后脱位合并同侧股骨干骨折是一种不常见的损伤类型,需要早期进行急救处理,随后迅速进行手术干预,以防止股骨头缺血性坏死。定期随访对于监测和评估髋关节状况至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad32/12302821/473782cf9f43/gr1.jpg

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