背景:髋臼后壁粉碎性骨折通常由高能量创伤引起,髋臼复杂的解剖结构使其治疗具有挑战性。然而,新鲜髋臼骨折合并股骨头坏死的治疗报道极为罕见。
方法:一位57岁的男性,在车祸中受伤,表现为右髋部疼痛和活动受限。50岁时,患者被诊断为右股骨头缺血性坏死,行走时经历右髋部疼痛和跛行,开始保守治疗。
方法:患者临床诊断为新鲜粉碎性髋臼后壁骨折和晚期股骨头坏死。
方法:我们应用3D打印技术和计算机辅助虚拟手术技术进行术前规划,模拟骨折复位,并设计了个性化的骨板和螺钉,用于固定髋臼后壁。单阶段全髋关节置换术治疗股骨头坏死。
结果:手术后1个月,他在步行者的帮助下开始行走,手术后6个月,髋臼后壁骨折有效愈合,让病人重返工作岗位。
结论:3D打印技术在髋臼内固定和全髋关节置换术中的应用有助于骨折评估,有利于顺利手术,促进骨折复位和愈合,恢复髋关节功能,并确保高水平的安全性。
BACKGROUND: Posterior wall comminuted fractures of the acetabulum are typically caused by high-energy trauma, and the complex anatomical structure of the acetabulum makes their treatment challenging. However,
reports of the treatment of fresh acetabular fractures combined with femoral head necrosis are extremely rare.
METHODS: A 57-year-old male, injured in a car accident, presented with right hip pain and limited mobility. At the age of 50, the patient was diagnosed with avascular necrosis of the right femoral head, experiencing right hip pain and a limp while walking, for which conservative treatment was initiated.
METHODS: The patient was clinically diagnosed with fresh comminuted posterior wall acetabular fracture and late-stage femoral head necrosis.
METHODS: We applied 3D printing technology and computer-assisted virtual surgical techniques for preoperative planning, simulated fracture reduction, and designed personalized bone plates and screws for fixation of the posterior wall of the acetabulum. A single-stage total hip arthroplasty was performed to treat femoral head necrosis.
RESULTS: He began walking with the assistance of a walker 1 month after surgery, and at 6 months post-surgery, the acetabular posterior wall fracture had effectively healed, allowing the patient to return to work.
CONCLUSIONS: The application of 3D printing technology in acetabular internal fixation and total hip arthroplasty is helpful for fracture assessment, facilitates smooth surgery, promotes fracture reduction and healing, restores hip joint function, and ensures a high level of safety.