| 股骨头毁损三联征:股骨头骨折-脱位合并股骨颈骨折 |
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Received:January 08, 2023
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| 期刊信息：《中国骨伤》2023年36卷，第3期，第216-221页 |
| DOI：10.12200/j.issn.1003-0034.2023.03.004 |
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| 股骨头合并同侧股骨颈骨折是一种严重而复杂的创伤,保髋手术大多会失败。其治疗的难点及预后的关键在股骨颈骨折上。鉴于股骨颈骨折的发生与股骨头骨折-脱位之间存在明显的、前后关联的贯序特点,笔者认为以股骨头毁损三联征(disastrous triad of femoral head,DTFH)来概括这种类型的损伤,更能反映其损伤机制和预后特点。结合临床观察和文献资料,DTFH可分为3个类型:Ⅰ型,普通型DTFH,股骨颈骨折的发生紧随于股骨头骨折-脱位之后,是同一暴力造成的损伤;Ⅱ型,医源型DTFH,是在股骨头骨折-脱位的诊疗过程中发生了医源性股骨颈骨折;Ⅲ型,应力型DTFH,发生于股骨头骨折-脱位的治疗之后,在股骨头骨折面的远侧缘发生应力性股骨颈骨折。本文对各型DTFH的临床特点进行了初步的讨论。 |
| [关键词]:股骨颈骨折 股骨头骨折 髋关节脱位 |
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| Disastrous triad of femoral head:femoral neck fracture meeting fracture-dislocation of femoral head |
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| Abstract:Femoral head and ipsilateral femoral neck fractures are serious and complicated injuries,which usually yield unsatisfactory results using conventional hip-preserving surgery. The key point of the management and prognosis mainly lies in femoral neck fractures. An apparent and consecutive relationship exists between femoral neck fractures and femoral head fracture-hip dislocation in such injuries. It is believed that disastrous triad of femoral head (DTFH) could summarize these specific injuries,and reflect the injury mechanism and prognostic characteristics. Based on our clinical observation and literature review,DTFH could be divided into three subgroups:TypeⅠ,common DTFH,in which femoral neck fractures occur following femoral head fractures-hip dislocation due to the same trauma; TypeⅡ,iatrogenic DTFH,in which femoral neck fractures come out in the caring process of femoral head fractures-hip dislocation; Type Ⅲ,stressed DTFH,in which femoral neck fractures occur after the management of femoral head fractures-hip dislocation. In the scenario,the line of femoral neck fractures locates distally to the femoral head fractures. Herein,we will discuss clinical characteristics of these types of DTFH. |
| KEYWORDS:Femoral neck fracture Femoral head fracture Hip dislocation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 梅炯.股骨头毁损三联征:股骨头骨折-脱位合并股骨颈骨折[J].中国骨伤,2023,36(3):216~221 |
| 英文格式: | MEI Jiong.Disastrous triad of femoral head:femoral neck fracture meeting fracture-dislocation of femoral head[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(3):216~221 |
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