Zhu L, Lin H, Luo D
Gulou Hospital, Medical College of Nanjing University.
Zhonghua Wai Ke Za Zhi. 1995 May;33(5):289-91.
164 cases of traumatic posterior dislocation of the hip, of which 26 were associated with fractures of the femoral head, about 15.9% incidence, were treated during the year from March 1982 to March 1993. According to the pipkin classification of fractures of the femoral head, 10 cases were type 1, 6 tupe 2, 2 type 3, and 8 type 4. Of the 26 cases, 24 received emergent radiography, with 22 diagnosed and 2 misdiagnosed. The other 2 cases were found prompt auto-reduction of dislocation of the femoral head, without emergent radiography. The 4 misdiagnosed cases, because of continued pain or redislocation, came back later for radiography and then were correctly diagnosed. Besides the routine anteroposterior radiograph of the hip, pelvic oblique radiography angled 45 degrees or 60 degrees, and frog-leg anteroposterior hip radiography were needed. The CT-directed pelvic oblique radiograph was found to be the most accurate determinant of the extent of fracture displacement and the presence of intrasarticular loose fragments. Among the 19 cases operated on, 16 showed excellent-good rate (50%), and among the 7 non-operated cases, of 6 showed excellent-good rate (33%). After follow up.
1982年3月至1993年3月期间，共治疗164例创伤性髋关节后脱位患者，其中26例合并股骨头骨折，发生率约为15.9%。根据股骨头骨折的pipkin分类，1型10例，2型6例，3型2例，4型8例。26例中，24例行急诊X线检查，22例确诊，2例误诊。另外2例股骨头脱位自行复位，未行急诊X线检查。4例误诊患者因持续疼痛或再脱位，后来复诊行X线检查后得以正确诊断。除髋关节常规正位X线片外，还需45度或60度骨盆斜位X线片及蛙式位髋关节正位X线片。CT引导下骨盆斜位X线片是确定骨折移位程度及关节内游离碎骨片存在与否的最准确方法。19例手术患者中，16例优良率为50%，7例非手术患者中，6例优良率为33%。随访后。
