Ferguson T A, Patel R, Bhandari M, Matta J M
Department of Orthopaedics University of California-Davis, Sacramento, CA 95817, USA.
J Bone Joint Surg Br. 2010 Feb;92(2):250-7. doi: 10.1302/0301-620X.92B2.22488.
Using a prospective database of 1309 displaced acetabular fractures gathered between 1980 and 2007, we calculated the annual mean age and annual incidence of elderly patients > 60 years of age presenting with these injuries. We compared the clinical details and patterns of fracture between patients > 60 years of age (study group) with those < 60 years (control group). We performed a detailed evaluation of the radiographs of the older group to determine the incidence of radiological characteristics which have been previously described as being associated with a poor patient outcome. In all, 235 patients were > 60 years of age and the remaining 1074 were < 60 years. The incidence of elderly patients with acetabular fractures increased by 2.4-fold between the first half of the study period and the second half (10% (62) vs 24% (174), p < 0.001). Fractures characterised by displacement of the anterior column were significantly more common in the elderly compared with the younger patients (64% (150) vs 43% (462), respectively, p < 0.001). Common radiological features of the fractures in the study group included a separate quadrilateral-plate component (50.8% (58)) and roof impaction (40% (46)) in the anterior fractures, and comminution (44% (30)) and marginal impaction (38% (26)) in posterior-wall fractures. The proportion of elderly patients presenting with acetabular fractures increased during the 27-year period. The older patients had a different distribution of fracture pattern than the younger patients, and often had radiological features which have been shown in other studies to be predictive of a poor outcome.
利用一个前瞻性数据库，该数据库收集了1980年至2007年间的1309例移位髋臼骨折病例，我们计算了60岁以上老年患者出现这些损伤的年平均年龄和年发病率。我们比较了60岁以上患者（研究组）和60岁以下患者（对照组）之间的临床细节和骨折类型。我们对老年组的X线片进行了详细评估，以确定先前描述的与患者预后不良相关的放射学特征的发生率。总共有235例患者年龄大于60岁，其余1074例年龄小于60岁。在研究期的前半期和后半期之间，髋臼骨折老年患者的发病率增加了2.4倍（分别为10%（62例）和24%（174例），p<0.001）。与年轻患者相比，以髋臼前柱移位为特征的骨折在老年患者中更为常见（分别为64%（150例）和43%（462例），p<0.001）。研究组骨折的常见放射学特征包括前骨折中单独的四边形板成分（50.8%（58例））和髋臼顶撞击（40%（46例）），以及后壁骨折中的粉碎（44%（30例））和边缘撞击（38%（26例））。在这27年期间，髋臼骨折老年患者的比例有所增加。老年患者的骨折类型分布与年轻患者不同，并且常常具有其他研究显示可预测不良预后的放射学特征。
