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采用带锁髓内钉治疗既往行髌骨切除术患者的复杂性髋关节后脱位及髋臼骨折:1例报告

Total Hip Arthroplasty with Cage Application for Complex Posterior Hip Dislocation and Acetabular Fracture in a Patient with Prior Patellectomy: A Case Report.

作者信息

Saraf Amit, Bishnoi Sandeep, Kumar S Krishna

机构信息

Department of Orthopaedics, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.

出版信息

J Orthop Case Rep. 2025 Sep;15(9):62-65. doi: 10.13107/jocr.2025.v15.i09.6016.

Abstract

INTRODUCTION

Neglected complex posterior hip dislocations with associated acetabular fractures are rare but challenging injuries. When compounded by biomechanical alterations such as a prior patellectomy, surgical planning becomes more complicated. Total hip arthroplasty (THA) with acetabular cage reconstruction is a viable salvage option to restore hip stability and function in such scenarios.

CASE REPORT

We report a case of a 42-year-old male with a chronic posterior dislocation of the right hip and a comminuted posterior wall and column acetabular fracture, presenting 2 months post-injury. The patient had previously undergone a right-sided patellectomy. Surgical intervention included THA with acetabular cage reconstruction due to segmental bone loss. At 6-month follow-up, the patient achieved pain-free ambulation, a stable prosthesis, and satisfactory functional outcomes.

CONCLUSION

This case highlights the successful use of acetabular cage-assisted THA in a patient with both complex hip trauma and altered knee biomechanics. Early intervention, comprehensive surgical planning, and the use of modern implants are key in managing such rare and challenging presentations.

摘要

引言

伴有髋臼骨折的复杂陈旧性髋关节后脱位较为罕见,但具有挑战性。若合并生物力学改变,如既往髌骨切除术,手术规划会变得更加复杂。在这种情况下,采用髋臼笼重建的全髋关节置换术(THA)是恢复髋关节稳定性和功能的可行挽救方案。

病例报告

我们报告一例42岁男性患者,受伤2个月后出现右髋慢性后脱位及髋臼后壁和柱粉碎性骨折。该患者既往曾接受右侧髌骨切除术。由于存在节段性骨丢失,手术干预包括采用髋臼笼重建的THA。在6个月的随访中,患者实现了无痛行走、假体稳定且功能结果令人满意。

结论

本病例突出了髋臼笼辅助THA在既有复杂髋部创伤又有膝关节生物力学改变的患者中的成功应用。早期干预、全面的手术规划以及现代植入物的使用是处理此类罕见且具有挑战性病例的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/211f/12422663/f69f14186fad/JOCR-15-62-g001.jpg

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