髋臼模拟横向、前柱和后柱骨折对髋关节稳定性的影响。

The effects of simulated transverse, anterior column, and posterior column fractures of the acetabulum on the stability of the hip joint.

作者信息

Vrahas M S, Widding K K, Thomas K A

机构信息

Department of Orthopaedic Surgery, Louisiana State University Medical Center, New Orleans 70112, USA.

出版信息

J Bone Joint Surg Am. 1999 Jul;81(7):966-74. doi: 10.2106/00004623-199907000-00009.

DOI:10.2106/00004623-199907000-00009

PMID:10428128

Abstract

BACKGROUND

Knowledge of the location of the weight-bearing portion of the acetabulum would assist orthopaedic surgeons in the treatment of acetabular fractures. With use of controlled experimental transverse, anterior column, and posterior column osteotomies, we investigated the weight-bearing region of the acetabulum.

METHODS

Twenty-four fresh-frozen cadaveric hip joints were tested. Simulated transverse fractures were evaluated in twelve specimens, and simulated anterior column and posterior column fractures were tested in six specimens each. Each femur and acetabulum was potted and mounted in an aluminum fixture, with the acetabulum positioned in 25 degrees of flexion and 20 degrees of abduction. Each specimen was tested intact and after successive osteotomies. The transverse osteotomies had roof-arc angles of 60, 50, 40, and 30 degrees. The anterior column and posterior column osteotomies were classified as very low, low, intermediate, or high. Compressive loading to 800, 1200, and 1600 newtons was performed four times for each intact specimen and after each osteotomy. A specimen was considered to be stable if no gross dislocation occurred during any of the four loading cycles. Translation of the femur within the acetabulum also was measured during each trial.

RESULTS

The number of stable specimens decreased both with higher applied loads and with more superior osteotomies. The stability of the hip was significantly affected by both the location of the fracture and the magnitude of the applied load (p < 0.00005). Translation of the femur within the acetabulum increased with higher applied loads and with more superior osteotomies.

CONCLUSIONS

Fractures that have a medial roof-arc angle of 45 degrees or less, an anterior roof-arc angle of 25 degrees or less, or a posterior roof-arc angle of 70 degrees or less cross the weight-bearing portion of the acetabulum and necessitate operative treatment.

摘要

背景

了解髋臼负重部分的位置有助于骨科医生治疗髋臼骨折。我们通过使用可控的实验性横行、前柱和后柱截骨术，对髋臼的负重区域进行了研究。

方法

对24个新鲜冷冻的尸体髋关节进行测试。在12个标本中评估模拟的横行骨折，在另外6个标本中分别测试模拟的前柱和后柱骨折。将每个股骨和髋臼装入盆中并固定在铝制夹具中，使髋臼处于25度屈曲和20度外展位。每个标本在完整状态下以及在连续截骨后进行测试。横行截骨的顶弧角度分别为60度、50度、40度和30度。前柱和后柱截骨分为极低、低、中或高等级。对每个完整标本以及每次截骨后，分别施加800、1200和1600牛顿的压缩载荷，进行4次加载。如果在任何一个加载周期中没有发生明显脱位，则认为标本稳定。在每次试验期间还测量了股骨在髋臼内的平移。