Quick Diagnosis of Non-displaced Fracture of the Femoral Neck: A Case Report

快速診斷未移位性股骨頸骨折：病例報告

簡建龍(Jiann-Long Jean) ； 李建和(Chian-Her Lee) ； 王世杰(Shyu-Jye Wang) ； 張志鴻(Jhi-Hong Chang) ； 唐秀蘭(Hsiou-Lan Tang) ； 施丞貴(Cherng-Gueih Shy) ； 吳興盛(Shing-Sheng Wu) ； 林柳池(Leou-Chyr Lin)

《中華放射線醫學雜誌》 25卷6期 (2000/12) Pp. 263-266

摘要

未移性性股骨頸骨折在老年人是一嚴重問題，通常在初時的X光片會因軟組織、骨質疏鬆、或射線照相技術而沒有被發現。延誤診斷常增加罹病率甚至醫療糾紛，若是發生股骨頸移位性骨折更有高比率的股骨頭缺血性壞死、未癒合、或是內翻變形等之合併症。早期診斷可以簡單及正確的處理，且可以得到較好的結果及縮短住院天數。傳統上另外可以用核醫骨掃瞄或核磁共振來早期偵測未移位性股骨頸骨折，但前者有於射性曝露，後者有檢查費用成本很高的缺點。本文中舉了一位老人髖部疼痛的病例，初時X光並沒有顯示出病灶，後我們患側下肢內轉30度照相後得到清晰的X光片來幫助診斷未移位性股骨頸骨折的案例。

關鍵字

股骨頸 ； 骨折 ； 缺血性壞死 ； 核磁共振

並列摘要

Non-displaced fractures of the femoral neck in the elderly are serious injuries. They may not be evident on initial radiographs due to overlying soft tissue, osteopenia, or radiographic techniques. Delay in diagnosis can increase associated medical, economic, and legal implications in the changing health care environment, since displacement can lead to avascular necrosis of the femoral head, nonunion, or varus deformity. Early and accurate detection can enable physicians to perform relatively simple surgical fixations in situ. Refinements in diagnosis can improve outcomes and minimize the duration of hospital stays. Traditionally, bone scans and magnetic resonance imaging (MRI) have been used for early detection of non-displaced femoral neck fractures. The disadvantages of these examination techniques include exposure to radiation and high costs, respectively. Initial radiographs of elderly patients were equivocal, but clear fracture lines were demonstrated after retaking the films while keeping the ipsilateral foot internally rotated at 30 degrees. This simple radiographic technique can enhance radiographic diagnosis of this elusive entity.

並列關鍵字

femoral neck ； fractures ； avascular necrosis ； MRI