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[手术治疗髋臼骨折的临床及影像学结果]

[Clinical and radiologic results of surgically-treated acetabular fractures].

作者信息

Elmali Nurzat, Ertem Kadir, Inan Muharrem, Ayan Irfan, Denizhan Yurdaer

机构信息

Inönü Universitesi Turgut Ozal Tip Merkezi Ortopedi ve Travmatoloji Anabilim Dali.

出版信息

Acta Orthop Traumatol Turc. 2003;37(2):97-101.

Abstract

OBJECTIVES

We evaluated the functional and radiologic results of surgical treatment in patients with displaced acetabular fractures.

METHODS

The study included 21 patients (13 males, 8 females; mean age 35 years; range 21 to 63 years). Before surgery, all the patients were evaluated with anteroposterior, iliac, and obturator oblique views and computed tomography scans. According to the Letournel-Judet classification, the fractures were simple in 10 patients and complex in 11 patients. Twelve patients had posterior wall and/or the posterior column fractures. Four patients underwent closed reduction under emergency settings for accompanying posterior dislocations. The mean time to surgery was 4.8 days (range 1 to 13 days). Surgery was performed by the Kocher-Langenbeck approach (n=12), a triradiate approach (n=5), and a modified extended iliofemoral approach (n=4). Functional results were assessed by the D'Aubigne-Postel's knee scoring system and radiologic results using anteroposterior, iliac, and obturator oblique views. The mean follow-up was 31 months (range 19 to 64 months).

RESULTS

Functional results were excellent in eight patients (38.1%), good in seven (33.3%), satisfactory in four (19.1%), and poor in two patients (9.5%). Radiologic examination showed posttraumatic arthrosis in four patients (19.1%), heterotopic ossification in three patients (14.3%), and avascular necrosis in two patients (9.5%). Radiologic results were excellent and good in 16 patients (76.2%), satisfactory in three patients (14.3%), and poor in two patients (9.5%).

CONCLUSION

Clinical and radiologic results showed concordance. The presence of dislocations and inadequate reduction were associated with poor functional results.

摘要

目的

我们评估了移位髋臼骨折患者手术治疗的功能和影像学结果。

方法

该研究纳入21例患者(13例男性,8例女性;平均年龄35岁;范围21至63岁)。手术前,所有患者均接受前后位、髂骨和闭孔斜位X线片及计算机断层扫描评估。根据Letournel-Judet分类,10例患者为简单骨折,11例患者为复杂骨折。12例患者有后壁和/或后柱骨折。4例患者因合并后脱位在急诊情况下接受了闭合复位。手术平均时间为4.8天(范围1至13天)。采用Kocher-Langenbeck入路手术12例,三放射入路手术5例,改良扩大髂股入路手术4例。功能结果采用D'Aubigne-Postel膝关节评分系统评估,影像学结果采用前后位、髂骨和闭孔斜位X线片评估。平均随访时间为31个月(范围19至64个月)。

结果

8例患者(38.1%)功能结果为优,7例(33.3%)为良,4例(19.1%)为满意,2例患者(9.5%)为差。影像学检查显示4例患者(19.1%)有创伤后关节炎,3例患者(14.3%)有异位骨化,2例患者(9.5%)有股骨头缺血性坏死。16例患者(76.2%)影像学结果为优和良,3例患者(14.3%)为满意,2例患者(9.5%)为差。

结论

临床和影像学结果显示一致。脱位和复位不充分与功能结果差相关。

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