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三联创伤性骨折脱位:一例罕见的同侧髋、膝和踝关节同时发生骨折脱位的病例并文献复习

Triple Traumatic Fracture-Dislocation: A Rare Case of Simultaneous Ipsilateral Hip, Knee, and Ankle Fracture-Dislocation with a Review of the Literature.

作者信息

Choudhary Laxman, Soni Bharat Kumar, Aggarwal Aakarsh, Rathor Kuldeep, Banerjee Sumit, Elhence Abhay

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

J Orthop Case Rep. 2025 Aug;15(8):11-17. doi: 10.13107/jocr.2025.v15.i08.5866.

Abstract

INTRODUCTION

Co-occurrence of ipsilateral hip, knee, and ankle fracture-dislocation is a rare condition demanding heightened urgency, constituting an emergency warranting immediate attention and utmost care. Delineating the management of such injury is required so that satisfactory functional outcomes can be achieved in this uncommon injury.

CASE REPORT

A 41-year-old male was alleged to have sustained a road traffic accident, following which he presented to the emergency department of a tertiary care center with pain over the left hip, knee, and ankle joints, and deformity of the same limb. He was evaluated and diagnosed with ipsilateral hip fracture-dislocation, knee fracture-dislocation, and bimalleolar ankle fracture with ankle subluxation. He underwent open reduction internal fixation (ORIF) with raft plate (7H) for the proximal tibia fracture and two Herbert screws for the tibial spine fracture for fixing the knee fracture-dislocation. ORIF with 2 CC screw for medial malleolus and ORIF with 1 CC screw for lateral malleolus was done to fix ankle fracture subluxation. No surgical intervention was required for hip fracture-dislocation.

CONCLUSION

Simultaneous ipsilateral hip, knee, and ankle fracture-dislocation is a rare condition that should be approached as a limb-threatening orthopedic emergency. We report this case for its rarity and to document that good results can be achieved with early appropriate care.

摘要

引言

同侧髋、膝和踝关节骨折脱位同时发生是一种罕见情况,需要高度紧急处理,构成一种急需立即关注和极度小心护理的急症。需要明确此类损伤的处理方法,以便在这种不常见的损伤中获得满意的功能结果。

病例报告

一名41岁男性据称遭遇了道路交通事故,事故发生后他前往一家三级护理中心的急诊科就诊,主诉左髋、膝和踝关节疼痛,且同一肢体出现畸形。经评估,他被诊断为同侧髋骨折脱位、膝骨折脱位以及双踝骨折伴踝关节半脱位。他接受了手术治疗,使用7H型接骨板对胫骨近端骨折进行切开复位内固定(ORIF),并使用两枚Herbert螺钉对胫骨棘骨折进行固定,以修复膝骨折脱位。分别使用2枚CC螺钉对内踝骨折进行ORIF,使用1枚CC螺钉对外踝骨折进行ORIF,以修复踝关节骨折半脱位。髋骨折脱位无需手术干预。

结论

同侧髋、膝和踝关节骨折脱位同时发生是一种罕见情况,应作为一种威胁肢体的骨科急症来处理。我们报告此病例是因其罕见性,并记录表明早期适当护理可取得良好结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02ea/12328988/53ec8dd708b5/JOCR-15-11-g001.jpg

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