Miller A N, Prasarn M L, Lorich D G, Helfet D L
Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY 10021, USA.
J Bone Joint Surg Br. 2010 Apr;92(4):560-4. doi: 10.1302/0301-620X.92B4.23494.
We have examined the accuracy of reduction and the functional outcomes in elderly patients with surgically treated acetabular fractures, based on assessment of plain radiographs and CT scans. There were 45 patients with such a fracture with a mean age of 67 years (59 to 82) at the time of surgery. All patients completed SF-36 questionnaires to determine the functional outcome at a mean follow-up of 72.4 months (24 to 188). All had radiographs and a CT scan within one week of surgery. The reduction was categorised as 'anatomical', 'imperfect', or 'poor'. Radiographs classified 26 patients (58%) as anatomical,13 (29%) as imperfect and six (13%) as poor. The maximum displacement on CT showed none as anatomical, 23 (51%) as imperfect and 22 (49%) as poor, but this was not always at the weight-bearing dome. SF-36 scores showed functional outcomes comparable with those of the general elderly population, with no correlation with the radiological reduction. Perfect anatomical reduction is not necessary to attain a good functional outcome in acetabular fractures in the elderly.
我们基于X线平片和CT扫描评估，研究了老年髋臼骨折手术治疗后的复位准确性及功能预后。共有45例此类骨折患者，手术时平均年龄为67岁（59至82岁）。所有患者均完成了SF - 36问卷，以确定平均随访72.4个月（24至188个月）时的功能预后。所有患者在术后一周内均进行了X线平片和CT扫描。复位情况分为“解剖复位”、“不完美复位”或“复位不佳”。X线平片将26例患者（58%）分类为解剖复位，13例（29%）为不完美复位，6例（13%）为复位不佳。CT显示的最大移位情况中，无解剖复位，23例（51%）为不完美复位，22例（49%）为复位不佳，但并不总是发生在负重穹顶处。SF - 36评分显示功能预后与一般老年人群相当，与放射学复位情况无关。对于老年髋臼骨折患者，实现良好的功能预后并不需要完美的解剖复位。
