Goulet J A, Bray T J
Section of Orthopaedic Surgery, University of Michigan, Ann Arbor 48109.
Clin Orthop Relat Res. 1989 Mar(240):9-20.
Displaced acetabular fractures belonging to the associated fracture group described by Judet and Letournel present a formidable diagnostic and therapeutic challenge. Of 116 acetabular fractures, 31 had associated fracture types with follow-up evaluation of one year or longer. The patients' mean age was 30.7 years, their mean injury severity score was 15, and the average follow-up period was 21 months. Four patients had failed previous acetabular surgery. Operating time averaged 4.5 hours. Mean blood loss was 1150 cc. Clinical results were satisfactory in 77% of cases, with 11 excellent, 13 good, four fair, and three poor results. Complex acetabular fractures can be reduced by a combined anterior and posterior approach designed by the authors. This approach offers significant advantages for visualization and stabilization of these fractures. The combined approach is recommended for the surgeon who has mastered the single-approach techniques for standard, simple fracture patterns.
属于Judet和Letournel所描述的相关骨折组的移位髋臼骨折带来了巨大的诊断和治疗挑战。在116例髋臼骨折中，31例伴有相关骨折类型，并进行了为期一年或更长时间的随访评估。患者的平均年龄为30.7岁，平均损伤严重程度评分为15分，平均随访期为21个月。4例患者先前的髋臼手术失败。手术时间平均为4.5小时。平均失血量为1150毫升。77%的病例临床结果令人满意，其中11例为优，13例为良，4例为可，3例为差。作者设计的前后联合入路可用于复位复杂髋臼骨折。这种入路为这些骨折的显露和固定提供了显著优势。对于已掌握标准、简单骨折类型单入路技术的外科医生，推荐采用联合入路。
