Laird A, Keating J F
Royal Infirmary, Edinburgh, Scotland.
J Bone Joint Surg Br. 2005 Jul;87(7):969-73. doi: 10.1302/0301-620X.87B7.16017.
We prospectively analysed the epidemiology of acetabular fractures over a period of 16 years in order to identify changes in their incidence or other demographic features. Our study cohort comprised a consecutive series of 351 patients with acetabular fractures admitted to a single institution between January 1988 and December 2003. There was no significant change in the overall incidence of acetabular fractures, which remained at 3 patients/100 000/year. There was, however, a significant reduction in the number of men sustaining an acetabular fracture over the period (p < 0.02). The number of fractures resulting from falls from a height < 10 feet showed a significant increase (p < 0.002), but there was no change in those caused by motor-vehicle accidents. There was a significant reduction in the median Injury Severity score over the period which was associated with a significant decrease in mortality (p < 0.04) and a reduction in the length of hospital stay. The incidence of osteoarthritis noted during follow-up of operatively-treated fractures declined from 31% to 14%, reflecting improved results with increasing subspecialisation. Our findings suggest that there will be a continuing need for some orthopaedic surgeons to specialise in the management of these fractures. In addition, the reductions in the Injury Severity score and mortality may be associated with improved road and vehicle safety.
我们对16年间髋臼骨折的流行病学情况进行了前瞻性分析，以确定其发病率或其他人口统计学特征的变化。我们的研究队列包括1988年1月至2003年12月期间连续收治于单一机构的351例髋臼骨折患者。髋臼骨折的总体发病率没有显著变化，仍为每年3例/10万。然而，在此期间，髋臼骨折男性患者数量显著减少（p<0.02）。从<10英尺高处坠落导致的骨折数量显著增加（p<0.002），但机动车事故导致的骨折数量没有变化。在此期间，损伤严重程度评分中位数显著降低，这与死亡率显著下降（p<0.04）和住院时间缩短有关。手术治疗骨折随访期间记录的骨关节炎发病率从31%降至14%，反映了随着专科化程度提高结果有所改善。我们的研究结果表明，仍将持续需要一些骨科医生专门从事这些骨折的治疗。此外，损伤严重程度评分和死亡率的降低可能与道路和车辆安全性的提高有关。
