Barquet A
Arch Orthop Trauma Surg (1978). 1981;98(1):69-72. doi: 10.1007/BF00389714.
Ipsilateral concomitant hip dislocation and femoral shaft fracture in childhood is extremely rare. A further case and a literature review, with 35 additional observations are presented. The dislocation was initially missed in more than 50% of cases, but when immediately diagnosed, closed reduction manoeuvres were effective in all observations but one, and results were rated normal. As delayed reduction predisposes to avascular necrosis, every child with a femoral shaft fracture should be given a routine X-rays of pelvis, including lateral hip views, as a safeguard against missing an associated hip dislocation. If present, its urgent closed reduction is imperious. In case of failure, closed or open purchasing of the proximal shaft fragment to allow a sort of skeletal-handling is to be used. Open reduction of the dislocation is to be regarded as the third-line procedure.
儿童同侧合并髋关节脱位和股骨干骨折极为罕见。本文报告了1例新病例并进行文献复习,另补充35例观察资料。超过50%的病例最初漏诊了脱位,但一旦立即诊断,除1例观察病例外,所有病例通过闭合复位手法均有效,结果评定为正常。由于延迟复位易导致缺血性坏死,因此,为防止漏诊合并的髋关节脱位,每个股骨干骨折患儿均应常规拍摄骨盆X线片,包括髋关节侧位片。若存在脱位,应立即进行紧急闭合复位。若复位失败,可采用闭合或切开复位近端骨折块,以进行某种形式的骨骼处理。脱位的切开复位应视为三线治疗方法。