Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China.
Chin Med J (Engl). 2013 Jul;126(14):2699-704.
Surgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma. The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.
The operative approaches, procedures, results, and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital. Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.
Sixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years). Excellent functional results were observed in 10 hip joints, good results in 40, fair results in 11, and poor results in nine. The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head, a time beyond 42 days from injury to operative management, and dislocation of femoral head during the injury. Some of the problems, which were observed included postoperative infection in two hips, iatrogenic sciatic nerve injury in eight hips, traumatic arthritis in 15 hips, heterotopic ossification in 17 hips, and necrosis of the femoral head in six hips.
A careful selection of operative indications for delayed acetabular fractures in combination with a proper operative approach and appropriate reduction and fixation could guarantee relatively good results.
髋臼骨折的手术治疗一直是骨科创伤领域的一个挑战。本研究旨在探讨髋臼骨折延迟治疗的手术方法，并评估手术效果。
回顾性分析 1995 年至 2005 年在北京积水潭医院治疗的髋臼骨折延迟手术患者的手术方法、手术过程、结果和并发症。采用 Merle d'Aubingne 和 Postel 骨折功能评分评估每位患者的生活质量，采用 Matta 放射学评分评估放射学结果。
68 例（70 髋）获得至少 5 年（平均 5.8 年）随访。10 髋功能结果优，40 髋良，11 髋可，9 髋差。预后不良的风险因素包括股骨头的撞击或软骨骨折、受伤至手术治疗的时间超过 42 天以及受伤时股骨头脱位。一些观察到的问题包括 2 髋术后感染、8 髋医源性坐骨神经损伤、15 髋创伤性关节炎、17 髋异位骨化和 6 髋股骨头坏死。
髋臼骨折延迟治疗的手术适应证选择要慎重，结合适当的手术入路、复位和固定，可保证较好的治疗效果。
