Traumatic Recurrent Dislocation of the Hip with Bankart Type Lesion - A Case Report -
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초록
성인 고관절의 재발성 탈구는 신경 근육성 질환이 있거나 고관절 이형성증이 있는 경우에 드물게 발생할 수 있다. 저자들은 비구의 후벽 골절이 동반된 고관절 탈구 환자에서 비구 후벽의 분쇄가 심해 고정이 힘들어 연부 조직만 봉합한 후, 적절한 보존적 치료를 하지 못한 환자에서 지속적인 재발성 탈구로 진행하였고, 고관절의 후벽이 견관절의 골성 Bankart 병변처럼 변화하고 대퇴 골두의 전내측은 골결손을 보여 정복이 유지되지 않아 고관절 인공관절 전 치환술을 시행한 예를 경험하였다. 수술 후 1년째에 고관절은 탈구없이 양호한 결과를 보이고 있었으며, 본 증례를 통해 고관절 후벽 고정의 중요성에 대해 강조하고자 한다.
Abstract
The recurrent dislocation of hip in adult can be uncommonly induced by neuromuscular disease or dysplasia of hip. But in the case of traumatic dislocation of hip with acetabular fracture, the possibility of recurrent dislocation can be decreased if treated with accurate fixation or traction. We have experienced a case of hip dislocation with comminuted acetabular fracture, which was treated only with soft tissue suture and without fixation because of severity of the acetabular fracture. An inappropriate conservative management was done during the post operation period, eventually result in recurrent dislocation and degeneration of posterior wall and head of femur which resembled bony Bankart lesion of the shoulder. The reduction was not able to be maintained, as a result THRA was done. A year after the operation, good prognosis was found in replaced hip without any recurrent dislocation.
참고문헌 (10)
- Heeg M, "Operative treatment for acetabular fractures", J Bone Joint Surg Br, 72, pp.383~386 (1990)
- Schlickewei W, "Hip dislocation without fracture: traction or mobilization after reduction?", Injury, 24, pp.27~31 (1993)
- Keith JE Jr, "Stability of posterior fracture-dislocations of the hip. Quantitative assessment using computed tomography", J Bone Joint Surg Am, 70, pp.711~714 (1988)
- Olson SA, "The computerized tomography subchondral arc: a new method of assessing acetabular articular continuity after fracture (a preliminary report)", J Orthop Trauma, 7, pp.402~413 (1993)
- Marchetti ME, "Intermediateterm experience of Pipkin fracture-dislocations of the hip", J Orthop Trauma, 10, pp.455~461 (1996)
- Daum WJ, "Traumatic posterior acetabular defects reconstructed with iliac crest autograft. A report of two cases", Clin Orthop Relat Res, (291), pp.188~192 (1993)
- Mears DC, "Displaced acetabular fractures managed operatively: indicators of outcome", Clin Orthop Relat Res, (407), pp.173~186 (2003)
- Weber M, "Recurrent traumatic dislocation of the hip: report of a case and review of the literature", J Orthop Trauma, 11, pp.382~385 (1997)
- Marti RK, "Chronic recurrent posterior dislocation of the hip after a Pipkin fracture treated with intertrochanteric osteotomy and acetabuloplasty. A case report", J Bone Joint Surg Am, 82, pp.867~872 (2000)
- Lieberman JR, "Recurrent dislocation of a hip with a labral lesion: treatment with a modified Bankart-type repair. Case report", J Bone Joint Surg Am, 75, pp.1524~1527 (1993)