Džupa V, Grill R, Fridrich F, Krbec M, Skála-Rosenbaum J, Báča V
Centrum pro integrované studium pánve 3. LF UK, Praha.
Acta Chir Orthop Traumatol Cech. 2013;80(1):60-3.
The aim of the study was to assess differences in the number and severity of associated injuries between patients with pelvic injury and those with acetabular fracture.
The patients treated in the period from January 1, 2008, to December 31, 2010, were enrolled. The group comprised 249 patients (130 women and 119 men) with pelvic injuries and 58 patients (14 women and 44 men) with acetabular fractures. In the patients with pelvic injury, the average age was 52 years, 61 in women and 43 in men, in the range of 17 to 91 years. In the patients with acetabular fracture, the average age was 54 years, 59 in women and 53 in men, in the range of 21 to 96 years. The relevant data including age, sex, cause of injury, associated injuries and the overall severity of injury were obtained from the patient database. The results were statistically analysed using Pearson's .2 test at a 5% level of significance.
Acetabular fractures were recorded in more men than women and this difference was significantly higher (p = 0.002) than in the patients with pelvic injury in whom similar numbers of men and women were affected. A fall from height was significantly more frequent as a cause of pelvic injury than that of acetabular fracture (p = 0.034). The patients with pelvic injury also had significantly more associated injuries (p = 0.016) and the number of these patients with an Injury Severity Score (ISS) higher than 16 was significantly higher compared with the number of patients with acetabular fractures (p < 0.001).
Little published information is available on comparison of the severity of injuries in patients with pelvic injuries and those with acetabular fractures because these conditions are in fact two nosological units. In pelvic injuries, as conditions usually accompanied by multiple trauma, associated injuries, risk factors for death, requirements for primary life-saving measures, complications and treatment outcomes have been studied. Less attention has been paid to these issues in patients with acetabular fractures; the authors focused on determining the quality of intra-articular fracture treatment in relation to a subsequent risk of avascular necrosis of the femoral head or early arthritis.
The study comparing the patients with pelvic injury with those having acetabular fracture showed a significantly higher proportion of men in the group with acetabular fractures. A fall from height significantly more often caused a pelvic injury than an acetabular fracture. In traffic accidents, drivers usually suffered acetabular fractures while pedestrians and cyclists had pelvic injuries. However, a significantly higher number of associated injuries and multiple trauma with an ISS > 16 recorded in the patients with pelvic injury in comparison with those with acetabular fractures was the most important difference between these two groups.
本研究旨在评估骨盆损伤患者与髋臼骨折患者相关损伤的数量及严重程度差异。
纳入2008年1月1日至2010年12月31日期间接受治疗的患者。该组包括249例骨盆损伤患者（130例女性和119例男性）以及58例髋臼骨折患者（14例女性和44例男性）。骨盆损伤患者的平均年龄为52岁，女性为61岁，男性为43岁，年龄范围在17至91岁之间。髋臼骨折患者的平均年龄为54岁，女性为59岁，男性为53岁，年龄范围在21至96岁之间。从患者数据库中获取包括年龄、性别、损伤原因、相关损伤及损伤总体严重程度等相关数据。结果采用Pearson卡方检验进行统计学分析，显著性水平为5%。
髋臼骨折患者中男性多于女性，且这一差异（p = 0.002）显著高于骨盆损伤患者，骨盆损伤患者中男性和女性的数量相近。高处坠落作为骨盆损伤的原因比髋臼骨折更为常见（p = 0.034）。骨盆损伤患者的相关损伤也显著更多（p = 0.016），且损伤严重度评分（ISS）高于16的骨盆损伤患者数量显著多于髋臼骨折患者（p < 0.001）。
关于骨盆损伤患者与髋臼骨折患者损伤严重程度比较的已发表信息较少，因为这两种情况实际上是两个病种单元。对于骨盆损伤，由于其通常伴有多发伤，已经对相关损伤、死亡危险因素、主要救命措施要求、并发症及治疗结果进行了研究。髋臼骨折患者在这些问题上受到的关注较少；作者主要关注确定关节内骨折治疗质量与股骨头缺血性坏死或早期关节炎后续风险的关系。
比较骨盆损伤患者与髋臼骨折患者的研究表明，髋臼骨折组男性比例显著更高。高处坠落导致骨盆损伤的情况比髋臼骨折更为常见。在交通事故中，驾驶员通常发生髋臼骨折，而行人及骑自行车者则发生骨盆损伤。然而，与髋臼骨折患者相比，骨盆损伤患者记录到的相关损伤及ISS>16的多发伤数量显著更多，这是两组之间最重要的差异。
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