摘要
股骨近端防旋髓内钉固定是股骨粗隆间骨折内固定的常用方法。手术固定后的动脉损伤是一种罕见但严重的并发症。本文报道1例患者,男,64岁,因"从农用车摔下致左髋部疼痛伴活动受限2 d"入院。根据X线结果,诊断为左股骨转子间骨折(AO分型31-A1.2,Evans-Jensen分型IIA型),完善检查,排除手术禁忌,于入院后第4 d行闭式复位髓内钉内固定术,手术顺利,骨折对位对线良好,拆线后出院。术后3个月因左大腿肿胀、疼痛再次入院。诊断为:左股骨转子间骨折PFNA固定术后迟发血肿形成,经清创止血治疗后痊愈。本文通过文献回顾,分析迟发血肿形成的可能原因、临床表现及治疗方法,为临床类似并发症的预防和诊治提供参考。
Proximal femoral nail anti-rotation(PFNA) is commonly used for internal fixation of intertrochanteric fractures. Arterial injury secondary to surgical fixation is a rare but serious complication. This paper reports a 64-year-old male patient who was admitted to our hospital for "left hip pain with limited movement for 2 days after falling from a farm vehicle". According to the X-ray films, the patient was diagnosed of left intertrochanteric fracture(AO type 31-A1.2, Evans Jensen type IIA). After preoperative examination was completed and the surgical contraindication was excluded, closed reduction and internal fixation with PFNA was performed on 4 days after admission.The operation was finished smoothly with satisfactory fracture reduction and fixation. As the suture was removed, the patient was discharged. Three months later, the patient was hospitalized again due to swelling and pain of left thigh, diagnosed of delayed hematoma(traumatic pseudoaneurysm) secondary to PFNA fixation of left intertrochanteric fracture, and successfully treated by debridement and hemostasis. In addition, a through literature review, focusing on possible causes, clinical manifestations and treatment methods of delayed hematoma were done in this paper, because it was clear that prevention was the best treatment.
作者
张立峰
贾燕飞
冯卫
佟雁翔
李亚光
于成涌
张哲汉
薛飞
王文选
高尚
ZHANG Li-feng;JA Yan-fei;FENG Wei;TONG Yan-xiang;LI Ya-guang;YU Cheng-yong;ZHANG Zhe-han;XUE Fei;WANG Wen-xuan;GAO Shang(Department of Orthopaedics,The Second Affiliated Hospital,Inner Mongolia Medical Universityf Hohhot 010030,China;Department of Anatomy,Inner Mongolia Medical University,Hohhot 010010,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第18期1673-1676,共4页
Orthopedic Journal of China
基金
内蒙古自然科学基金项目(编号:2017MS08100)
内蒙古医科大学科技百万工程项目[编号:YKD2016KJBW(LH)017]
内蒙古医科大学科技百万项目(编号:YKD2017KJBW015)。
关键词
股骨转子间骨折
并发症
血肿
intertrochanteric fracture
complications
hematoma
