west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "髋关节后脱位" 5 results
  • TREATMENT OF Pipkin TYPE I FRACTURE OF FEMORAL HEAD ASSOCIATED WITH POSTERIOR DISLOCATION OF THE HIP

    Objective To evaluate and compare the outcomes of simple closed reduction, selective fragment excision after closed reduction, and emergency fragment excision and reduction in the treatment of Pipkin type I fracture of femoral head associated with posterior dislocation of the hip. Methods Between January 2002 and January 2008, 24 patients with Pipkin type I fracture of the femoral head associated with posterior dislocation of the hip were treated with simple closed reduction (closed reduction group, n=8), with selective fragment excision after closed reduction (selective operation group, n=8), and with emergency fragment excision and reduction (emergency operation group, n=8). In the closed reduction group, there were 6 males and 2 females with an average age of 37.6 years (range, 19-56 years); injuries were caused by traffic accident in 6 cases, by fall ing from height in 1 case, and by crushing in 1 case with a mean disease duration of 3.1 hours (range, 1.0-7.5 hours); and the interval from injury to reduction was (4.00 ± 2.14) hours. In the selective operation group, there were 7 males and 1 female with an average age of 37.3 years (range, 21-59 years); injuries were caused by traffic accident in 7 cases and by fall ing from height in 1 case with a mean disease duration of 3.2 hours (range, 1.0-6.0 hours); and the interval from injury to reduction was (3.90 ± 1.47) hours. In the emergency operation group, there were 5 males and 3 females with an average age of 35.5 years (range, 20-58 years); injuries were caused by traffic accident in 5 cases, by fall ing from height in 1 case, and by crushing in 2 cases with a mean disease duration of 3.3 hours (range, 1.5-6.5 hours); and the interval from injury to open reduction was (5.10 ± 2.04) hours. There was no significant difference in the age, gender, disease duration, and interval from injury to reduction among 3 groups (P gt; 0.05). Results All wounds in selective operation group and emergency operation group healed primarily. All the patients were followed up 24 to 58 months (mean, 38.7 months). According to Thompson-Epstein system, the excellent and good rates were 50.0% (4/8) in the closed reduction group, 87.5% (7/8) in the selective operation group, and 87.5% (7/8) in the emergency operation group at 24 months after operation, showing significant difference among 3 groups (χ2=9.803, P=0.020). Heterotopic ossification was found in 1 case (12.5%) of the closed reduction group, in 4 cases (50.0%) of the selective operation group, and in 4 cases (50.0%) of the emergency operation group, and avascular necrosis of femoral head was found in 2 cases (25.0%) of the closed reduction group; there was no significant difference in compl ications among 3 groups (P gt; 0.05). Conclusion The treatment of Smith-Petersen approach and fragment excision by selective operation or emergency operation has similar outcome, which are better than the treatment of simple closed reduction.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • APPLICATION OF ACETABULAR TRIDIMENSIONAL MEMORYALLOY-FIXATION SYSTEM IN TREATMENT OF POSTERIOR WALL ACETABULAR FRACTURE WITH POSTERIOR DISLOCATION OF HIP

    Objective To investigate the cl inical effect of the acetabular tridimensional memoryalloy-fixation system (ATMFS) in treatment of posterior wall acetabular fractures with posterior dislocation of hip. Methods From January 2004 to February 2006, 15 cases of posterior wall acetabular fracture with posterior dislocation of hip were treated. There were 11males and 4 females, aged 21-68 years old with an average of 43.5 years old. Injury was caused by traffic accident in 8 cases, by fall ing from height in 5 cases and others in 2 cases. The locations were the left hip in 9 cases and the right hip in 6 cases. According to Thompson-Epstein’ fracture classification, there were 6 cases of type II, 5 cases of type III, 2 cases of type IV and 2 cases of type V. Imaging showed the acetabular articular surface displacement of 2-5 mm(mean 3 mm). The time from injury to hospital ization was 6 hours to 2 weeks(mean 1.5 days). Skeletal traction on femoral condyle was given, manual reduction was performed in 12 patients and intra-operative reduction in 3 cases. ATMFS was used after 2-7 days of hospital ization, and 4 cases received autologous free il ium because of bone defect. Results The operative time was 90-390 minutes with an average of 210 minutes. Intraoperative blood loss was 350-2 500 mL with an average of 360 mL. The hospital ization days of the patients ranged from 7 to 21 days(mean 10 days). Epidermal infection occurred and was cured after symptomatic management in 1 case. Other incisions healed by first intention. No deep infections, pulmonary embol ism, deep venous thrombosis and other compl ications occurred. The patients were followed up 1 to 3 years with an average of 1.6 years. Ischemic necrosis of femoral head occurred in 1 case. Heterotopic ossification in grade II occurred in 1 case. The hip function was still good without special treatment. According to Matta’s X-ray fracture reduction assessment, the results were excellent in 7 cases, good in 5 cases, fair in 2 cases, and poor in 1 case, the excellent and good rate was 80%. According to d’Aubigné cl inical efficacy evaluation, the results were excellent in 8 cases, good in 5 cases, fair in 1 case, and poor in 1 case, the excellent and good rate was 86.7% at last followup. Conclusion ATMFS can be used for the treatment of posterior wall acetabular fracture with posterior dislocation of hip, which can improve the anatomy corresponding rate of the femoral head and reduce the incidence of compl ications and restore the function of the hip.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 罕见双侧髋关节后脱位伴双侧股骨头骨折修复一例

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 髋关节后脱位合并股骨头骨折术后近期疗效

    目的 总结髋关节后脱位合并股骨头骨折手术后近期疗效。 方法 2001年3月~2003年5月收治8例髋关节后脱位合并股骨头骨折,年龄23~46岁。按Pipkin分型,其中Ⅰ型4例,Ⅱ型3例,Ⅳ型1例;合并多发肋骨骨折2例,颅脑损伤、腰椎压缩骨折、患侧坐骨神经损伤各1例。分别采用不同的手术入路给予治疗。 结果 术后经9~24个月随访,7例骨折愈合;1例4个月骨折块坏死吸收。按赵炬才等髋关节功能评价标准:优6例,良2例。结论 对髋关节后脱位合并股骨头骨折,应早期复位髋关节脱位,骨折块行有效的内固定,术后结合早期功能锻炼,可减少股骨头缺血坏死和创伤性关节炎的发生。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • Modified Hueter direct anterior approach for treatment of Pipkin type Ⅰ and Ⅱ femoral head fractures

    ObjectiveTo discuss the effectiveness of the modified Hueter direct anterior approach in treatment of Pipkin typeⅠ and Ⅱ femoral head fractures.MethodsBetween September 2014 and May 2016, 12 patients with Pipkin type Ⅰ and Ⅱ femoral head fractures were treated with the modified Hueter direct anterior approach. There were 8 males and 4 females, aged from 32 to 60 years (mean, 40.2 years). The disease causes included traffic accident injury in 9 cases and falling from height injury in 3 cases. According to Pipkin typing, 8 cases were rated as type Ⅰ and 4 cases as type Ⅱ. The interval of injury and admission was 2-28 hours (mean, 7.2 hours). Reduction was performed in all patients within 6 hours after admission, and then bone traction was given. The operation was performed in 3-7 days (mean, 4.3 days) after redution. The modified Hueter direct anterior approach was applied to expose and fix femoral head fractures by Herbert screws compressively. The operation time and intraoperative blood loss were recorded, and the effectiveness was evaluated according to the Thompson-Epstein scale at last follow-up.ResultsThe operation time was 80-130 minutes (mean, 97.5 minutes), and the intraoperative blood loss was 100-200 mL (mean, 130.2 mL). All fractures achieved anatomical reduction and successful fixation. All 12 patients were followed up 12-32 months (mean, 24.3 months). All patients achieved bone union in 15-20 weeks (mean, 16.3 weeks) and no wound infection, lateral femoral cutaneous nerve injury, osteonecrosis of the femoral head, or heterotopic ossification occurred. Traumatic arthritis occured in 3 patients. According to the Thompson-Epstein scale at last follow-up, the results were excellent in 5 cases, good in 5 cases, fair in 2 cases, and the excellent and good rate was 83.3%.ConclusionThe modified Hueter direct anterior approach has the advantages of clear anatomic structure, less trauma, and shorter operation time, and it can effectively expose and fix the Pipkin typeⅠ and Ⅱ femoral head fractures.

    Release date:2018-03-07 04:35 Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content