Gänsslen A, Oestern H J
Klinik für Unfallchirurgie, Orthopädie und Neurotraumatologie, Allgemeines Krankenhaus Celle, Siemensplatz 4, Celle, Germany.
Chirurg. 2011 Dec;82(12):1133-48, quiz 1149-50. doi: 10.1007/s00104-011-2135-3.
Treatment of acetabular fractures requires extensive knowledge of the bony anatomy, the amount of possible exposure of the bone with the selected approaches and fracture type-dependent indications of operative treatment. Classification of the fracture with detailed analysis of the fracture morphology is the basis for decision making and planning. The primary treatment aim is the anatomic reconstruction of the acetabulum which results in optimal long-term results.The basis of this overview is the presentation of standard treatment concepts in acetabular fracture surgery. Beside characteristics of the acetabular bony anatomy, biomechanical and pathomechanical principles and the relevant radiological anatomy, the treatment options, both conservative and operative and basic principles of the indications for standard surgical approaches will be discussed.The special fracture type is discussed in detail regarding incidence, injury mechanism, concomitant injuries, options for conservative and operative treatment, quality of operative reduction and long-term results.Furthermore, epidemiological data on typical postoperative complications are evaluated.
髋臼骨折的治疗需要对骨骼解剖结构有广泛的了解，包括所选手术入路可能暴露的骨量以及与骨折类型相关的手术治疗指征。对骨折进行分类并详细分析骨折形态是决策和规划的基础。主要治疗目标是髋臼的解剖重建，以获得最佳的长期效果。本综述的基础是介绍髋臼骨折手术的标准治疗概念。除了髋臼骨骼解剖结构的特点、生物力学和病理力学原理以及相关的放射解剖学外，还将讨论保守和手术治疗选择以及标准手术入路指征的基本原则。将详细讨论特殊骨折类型的发病率、损伤机制、合并损伤、保守和手术治疗选择、手术复位质量和长期效果。此外，还将评估典型术后并发症的流行病学数据。
