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首页> 外文期刊>Nagoya journal of medical science >Acetabular fracture non-union with pelvic discontinuity treated with two-stage total hip arthroplasty after intra- and extra-articular plate fixation
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Acetabular fracture non-union with pelvic discontinuity treated with two-stage total hip arthroplasty after intra- and extra-articular plate fixation

机译：关节内及关节外钢板固定后两阶段全髋置换术治疗髋臼骨折并骨盆不连

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摘要

Surgical intervention for the treatment of acetabular fracture non-union is often challenging. Here, we present a case of acetabular fracture non-union with pelvic discontinuity in a patient who underwent cemented total hip arthroplasty (THA) after intra- and extra-articular plate fixation. The case was a 70-year-old male with left T-shaped acetabular fracture non-union neglected for 5 months after the injury. The anterior and posterior columns were not healed, and the articular surface was displaced toward the medial side with a protrusion of the collapsed femoral head. As the first surgical intervention, we performed intra- and extra-articular plate fixation after femoral head decapitation. We fixed non-union regions from the inferior acetabular margin to the anterior column using a pelvic reconstruction plate bent three-dimensionally at the acetabular curvature on the intra-articular side. Furthermore, we fixed that of the posterior column on the outside of the acetabulum using a bent pelvic reconstruction plate. Union of the anterior and posterior columns was observed at 4 and 6 months after the first surgical intervention. At 7 months, we performed a cemented THA without additional bone grafting. At 1-year follow-up, the patient did not have left coxalgia and could walk without any gait supports. Based on our experience, we propose this surgical protocol as a useful treatment option for cases of acetabular fracture non-union.
机译：髋臼骨折不愈合的外科手术治疗通常具有挑战性。在这里，我们介绍了一个在关节内和关节外板固定后接受了全髋关节置换术（THA）的患者中，髋臼骨折伴骨盆不连续的情况。该例为一名70岁男性，受伤后5个月被忽视，左T形髋臼骨折不愈合。前柱和后柱未愈合，并且关节面向内侧移位，股骨头塌陷。作为第一个外科手术，我们在股骨头断头术之后进行了关节内和关节外板固定。我们使用在髋臼曲率在关节内侧三维弯曲的骨盆重建板，将髋臼下缘至前柱的非骨性区域固定。此外，我们使用弯曲的骨盆重建板将后柱的骨固定在髋臼外侧。首次手术后4个月和6个月观察到前柱和后柱的结合。在7个月时，我们进行了骨水泥化THA，而未进行其他植骨。在1年的随访中，该患者没有左颈痛，可以步行而无需任何步态支撑。根据我们的经验，我们提出该手术方案作为髋臼骨折不愈合病例的有用治疗选择。

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