背景:不对称双侧髋关节脱位在文献中很少报道。我们报告了一个34岁男性的不对称创伤性双侧髋关节脱位的独特病例,描述管理和术后并发症。
方法:一名34岁的卡车司机在坐在乘客座位上的两辆卡车之间发生碰撞时头部受伤。由于他在创伤17小时后被转诊,因此在我们机构的介绍有所延迟。经过评估,同一天,他在静脉麻醉下闭合复位了两个臀部。复位后评估显示左侧后壁骨折,由于复位后不稳定而被怀疑。使用两个弹簧板进行骨折的固定。患者在整个康复过程中以及之后恢复职业时都得到了随访。事件发生六个月后,病人没有痛苦,全范围的活动的两个臀部。手术三年后,放射学检查显示提示早期缺血性坏死(AVN)的变化,然而,患者没有任何功能限制.
结论:这是一例双侧不对称髋关节脱位伴左侧后壁骨折的病例。重要的是减少髋部并尽早解决骨折以防止AVN。
BACKGROUND: Asymmetric bilateral hip dislocations are very rarely reported in literature. We report a unique case of asymmetric traumatic bilateral hip dislocation in a 34-year-old male, describing the management and post-operative complications.
METHODS: A 34-year-old truck driver sustained injury to both his hips in a head on collision between two trucks while seated in the passenger seat. There was a delay in presentation at our institution as he was referred after 17 h of the trauma. After evaluation, he underwent closed reduction of both hips under intravenous anesthesia on the same day. The post-reduction assessment revealed a left-sided posterior wall fracture which was suspected due to the instability after reduction. Fixation of the fracture was done using two spring plates. The patient was followed up throughout his rehabilitation and thereafter when he resumed his occupation. Six months after the incident, the patient had pain-free, full range of motion of both hips. Three years after the surgery radiological investigations revealed changes suggestive of early avascular necrosis (AVN), however, the patient did not have any functional restriction.
CONCLUSIONS: This is a case of bilateral asymmetric hip dislocation with left side posterior wall fracture. It is important to reduce the hip and also address the fracture as early as possible to prevent AVN.