Obturator dislocation is a rare type of hip dislocation,accounting for about 2%-5%of all hip dislocations.The occurrence of old unreduced obturator dislocation is even more infrequent,with only 17 cases reported in ni...Obturator dislocation is a rare type of hip dislocation,accounting for about 2%-5%of all hip dislocations.The occurrence of old unreduced obturator dislocation is even more infrequent,with only 17 cases reported in nine studies,most of which were from the 1950s to 1980s in developing countries.CASE SUMMARY A 38-year-old woman from Hunan Province,China presented with stiffness of the left hip in abduction,flexion,and external rotation after falling from a 2-meter-tall tree onto her left knee 1.5 mo prior.Pelvic radiograph and computed tomography revealed obturator dislocation of the left hip accompanied by impaction fracture at the superolateral aspect of the left femoral head without associated acetabulum fracture.Open reduction was performed,resulting in restoration of the concentric alignment of the left hip.After surgery,6-wk skin traction was applied and the patient was kept in bed for an additional 2 wk.At 3 mo after surgery,the patient reported experiencing some pain,which did not affect the function of the affected limb,and some movement restriction but no abduction deformity or claudication was present.An X-ray showed that the left hip was homocentric,and there was no sign of posttraumatic arthritis or avascular necrosis.CONCLUSION Open reduction may be an effective treatment strategy for the rare condition of old unreduced obturator dislocation with short neglect time.展开更多
BACKGROUND Acetabular anterior wall fracture with preservation of the pelvic brim is extremely rare.It is different from anterior wall fracture classified by Judet and Letournel.Few studies have reported cases treated...BACKGROUND Acetabular anterior wall fracture with preservation of the pelvic brim is extremely rare.It is different from anterior wall fracture classified by Judet and Letournel.Few studies have reported cases treated by open reduction and internal fixation via the Smith-Petersen or iliofemoral approach.CASE SUMMARY We report a 48-year-old Chinese woman who had difficulty moving her right hip from abduction and external rotation after falling from 3 m.Pelvic radiograph and three-dimensional reconstruction of computed tomography revealed acetabular anterior wall fractures combined with fractures of the anterior inferior iliac spine and the iliac wing but not involving the pelvic brim.First,the patient underwent interim management by closed reduction of the hip dislocation and skin traction for 6 d.Then,we used a modified pararectus approach for treatment to fix the acetabular fractures with a reconstruction plate and nonlocking T-shape plate.At the 9-mo follow-up,the patient could walk painlessly without necrosis of the femoral head or heterotopic ossification,and the X-rays and computed tomography scan reconstructions showed good bone union.CONCLUSION The modified pararectus approach described here can facilitate exposure,reduction,and osteosynthesis for atypical acetabular fracture with less invasiveness.展开更多
基金The Grant of Xiangya Famous Doctors of Central South University,No.201468.
文摘Obturator dislocation is a rare type of hip dislocation,accounting for about 2%-5%of all hip dislocations.The occurrence of old unreduced obturator dislocation is even more infrequent,with only 17 cases reported in nine studies,most of which were from the 1950s to 1980s in developing countries.CASE SUMMARY A 38-year-old woman from Hunan Province,China presented with stiffness of the left hip in abduction,flexion,and external rotation after falling from a 2-meter-tall tree onto her left knee 1.5 mo prior.Pelvic radiograph and computed tomography revealed obturator dislocation of the left hip accompanied by impaction fracture at the superolateral aspect of the left femoral head without associated acetabulum fracture.Open reduction was performed,resulting in restoration of the concentric alignment of the left hip.After surgery,6-wk skin traction was applied and the patient was kept in bed for an additional 2 wk.At 3 mo after surgery,the patient reported experiencing some pain,which did not affect the function of the affected limb,and some movement restriction but no abduction deformity or claudication was present.An X-ray showed that the left hip was homocentric,and there was no sign of posttraumatic arthritis or avascular necrosis.CONCLUSION Open reduction may be an effective treatment strategy for the rare condition of old unreduced obturator dislocation with short neglect time.
基金Supported by the Xiangya Famous Doctors of Central South University,No.201468.
文摘BACKGROUND Acetabular anterior wall fracture with preservation of the pelvic brim is extremely rare.It is different from anterior wall fracture classified by Judet and Letournel.Few studies have reported cases treated by open reduction and internal fixation via the Smith-Petersen or iliofemoral approach.CASE SUMMARY We report a 48-year-old Chinese woman who had difficulty moving her right hip from abduction and external rotation after falling from 3 m.Pelvic radiograph and three-dimensional reconstruction of computed tomography revealed acetabular anterior wall fractures combined with fractures of the anterior inferior iliac spine and the iliac wing but not involving the pelvic brim.First,the patient underwent interim management by closed reduction of the hip dislocation and skin traction for 6 d.Then,we used a modified pararectus approach for treatment to fix the acetabular fractures with a reconstruction plate and nonlocking T-shape plate.At the 9-mo follow-up,the patient could walk painlessly without necrosis of the femoral head or heterotopic ossification,and the X-rays and computed tomography scan reconstructions showed good bone union.CONCLUSION The modified pararectus approach described here can facilitate exposure,reduction,and osteosynthesis for atypical acetabular fracture with less invasiveness.
