15岁男性Delbet Ib型股骨头经骺端骨折和髋臼后柱骨折22个月后的良好结果

IF 0.4 Q4 ORTHOPEDICS Case Reports in Orthopedics Pub Date : 2022-04-21 DOI:10.1155/2022/1843367
S. A. Sethuraman, A. Morse, J. Guzman, R. Cristofaro, D. Asprinio
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引用次数: 1

摘要

病例1例15岁男性患者在一次低能绊倒和跌倒后发生右侧股骨后部脱位Delbet型Ib骨骺骨折分离和右侧髋臼后柱骨折。紧急闭合复位,用空心螺钉固定股骨骨骺。两天后通过Kocher-Langenbeck入路行髋臼骨固定术。伤后22个月,患者右下肢能负重,无影像学证据显示无血管坏死,无疼痛或功能缺损的临床证据。结论在Delbet和Colonna分类中,股骨骨干骨骺骨折分离仅占未成熟股骨颈骨折的8%。同侧髋关节脱位的预后较差,因为旋股内侧动脉断裂有发生缺血性坏死的危险。紧急转介到创伤中心和适当的专家治疗后,这种不常见的创伤损伤模式良好的长期效果。
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Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male
Case A fifteen-year-old male patient sustained a posteriorly dislocated right capital femoral Delbet type Ib epiphyseal fracture-separation and a right acetabular posterior column fracture after a low-energy trip and fall. The capital femoral epiphysis was closed reduced and fixed with cannulated screws on an urgent basis. He underwent acetabular osteosynthesis via a Kocher-Langenbeck approach two days thereafter. Twenty-two months after injury, he was weight-bearing on the right lower extremity without radiologic evidence of avascular necrosis or clinical evidence of pain or functional deficit. Conclusion Fracture-separation of the capital femoral epiphysis comprises only 8% of skeletally immature femoral neck fractures in the Delbet and Colonna classification. Prognosis is worse with ipsilateral hip dislocation due to the risk of avascular necrosis from disruption of the medial femoral circumflex artery. Urgent referral to a trauma center and treatment by appropriate specialists enables good long-term results after this uncommon traumatic injury pattern.
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