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題名 | Traumatic Anterior Dislocation of Hip=創傷性髖關節前位脫臼 |
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作者 | 沈賢宗; 王世杰; 白偉民; 敖曼冠; Shen, Hsain-chung; Wang, Shyu-jye; Pai, Wei-ming; Au, Man-kun; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19960300、19960400 |
卷期 | 29:2 民85.03-04 |
頁次 | 頁132-137 |
分類號 | 416.61 |
語文 | eng |
關鍵詞 | 創傷性髖關節; 前位脫臼; Anterior dislocation of hip; Epstein's classification; Indentation fracture; Osteonecrosis; |
中文摘要 | 三軍總醫院從I985年I月到I995年3月間,共治療八例創傷性體關節前位 脫白。其中男性六位,女性兩位,平均年齡為39.8歲。依照EpsteIn的分類,七 例為下位脫白,一例為上位脫白。造成下位脫白的主要機轉為體關節外展。外旋 和彎曲,上位脫白則為外展,外旋和伸展。八例申。七例在平均5.2小時之內接 受全身靜脈麻醉,並以牽引、彎曲、內旋等方式完成閉鎖位復位,術後並以皮后 或骨骼牽引平均If.2天。另一例上位脫白因接受傳統接骨師錯誤的復位,而造成 股骨頸骨折。八例中,三例合併有股骨頭凹痕性骨折。除一例死亡,一例接受雙 極性半髖人工關節置換術,兩例追蹤時間少於兩年外,其餘四例平均追蹤51.3個 月。三位得到無痛,活動範圍正常的滿意結果。並且無創傷後關節炎產生。另一 位合併有四公釐凹痕性股骨頭骨折於受傷後22個月發生股骨頭缺血性壞死而得 到不良結果。 |
英文摘要 | Eight traumatic anterior dislocations of the hip were treated at Tri-ServiceGeneral Hospital during the 10-year period from 1985 to 1995. The patientswere six males and two females, with an average age was 39.8 years. According to Epstein's classification, there were seven obturator (inferior) andone pubic (superior) types. Abduction, external rotation and flexion of hipwas the mechanism for inferior type dislocation; abduction, external rotation with extension resulted in superior type dislocation. Closed reductionby traction, flexion, internal rotation of hip was done within an average of5.2 hours under IV general anesthesia in seven cases. Post-reduction skin(or skeletal) traction was applied for an average of 15.2 days (range: 1-21days). Femoral neck fracture following closed reduction by traditional bone-setter was found in one case with type I anterior dislocation of the hip. Inthree of eight patients fractures of the femoral head were noted; all were ofthe indentation type. Four patients were followed for at least two years, oran average of 51.3 months. Excellent results, pain-free and no post-trauma-tic arthritis, were noted in three cases. One case with indentation fracturethat was more than four millimeters in depth had fair clinical result anddeveloped osteonecrosis of the femoral head about 22 months after theinjury. |
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