合併關節緣損傷之復發性髖關節脫臼：以改良式Bankart氏修補法修補

Recurrent Dislocation of the Hip with Labral Lesion: Treatment by Modified Bankart-type Repair

林維群(Wei-Chun Lin) ； 許弘昌(Horng-Chaung Hsu)

《Mid-Taiwan Journal of Medicine》 11卷2期 (2006/06) Pp. 138-142

https://doi.org/10.6558/MTJM.2006.11(2).10

摘要

髖關節之復發性脫臼大部份發生於髖臼發育不良(acetabular dysplasia)，人工髖關節置換手術後，或是因創傷造成髖臼骨的包覆缺失所造成。類似肩關節因關節緣損傷(labral lesion)造成復發性脫臼則甚為罕見。本病例為29歲男性，原始之創傷為髖臼後位之骨折合併脫臼在他院接受骨折及脫臼開放性復位及內固定術。因復發性髖關節脫臼，手術探查發現骨折處已癒合完全，髖臼骨完好。但發現後上髖臼關節緣損傷，類似肩關節復發性脫臼狀況。我們以改良式Bankart氏修補去(modified Bankart-type repair)予以修補，即未曾再發生脫臼。術後追蹤四年，病患行動能力以及右髖關節活動範圍皆正常。

關鍵字

關節緣損傷 ； 改良式Bankart氏修補法 ； 復發性髖關節脫臼

並列摘要

We present a patient with recurrent dislocation of the hip. The initial injury had been a posterior wall fracture of the acetabulum which was corrected by open reduction with staple fixation in another hospital. The hip had not been immobilized or protected from weight-bearing activities after treatment. Recurrent dislocation occurred 8 months after the initial treatment. Exploration of the unstable hip revealed complete union of the fracture without an acetabular bony defect; however, disruption of the posterosuperior labrum by a pouch which had formed between the posterior acetabular wall and the short rotator muscles was noted. The capsule was repaired using T-plasty for reinforcement and only soft tissue procedures were done. After a two-year follow-up, no hip dislocation had occurred. This case report demonstrates the importance of the capsule and labrum in the stability of the hip.

並列關鍵字

labral lesion ； modified Bankart-type repair ； recurrent hip dislocation