Butterwick Derek, Papp Steve, Gofton Wade, Liew Allan, Beaulé Paul E
Division of Orthopedic Surgery, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. E-mail address for S. Papp:
J Bone Joint Surg Am. 2015 May 6;97(9):758-68. doi: 10.2106/JBJS.N.01037.
Acetabular fracture patterns in the elderly, with increased involvement of the anterior column, quadrilateral plate comminution, medialization of the femoral head, and marginal impaction, differ from those noted among a younger cohort. Poor prognostic factors for open reduction and internal fixation (ORIF) are posterior wall comminution, marginal impaction of the acetabulum, a femoral head impaction fracture, a so-called gull sign, and hip dislocation. The rate of conversion to total hip arthroplasty following formal ORIF has been reported to be 22% at a mean of twenty-nine months. Total hip replacement after an acetabular fracture generally yields good clinical results; however, in the acute setting, it must be combined with proper stable fracture fixation.
老年人髋臼骨折的类型与年轻人群不同，前者前柱受累增加、四边形板粉碎、股骨头内移和边缘嵌插更为常见。切开复位内固定（ORIF）的不良预后因素包括后壁粉碎、髋臼边缘嵌插、股骨头嵌插骨折、所谓的海鸥征和髋关节脱位。据报道，正规ORIF术后转为全髋关节置换术的发生率在平均29个月时为22%。髋臼骨折后行全髋关节置换术通常可取得良好的临床效果；然而，在急性期，必须结合适当的稳定骨折固定。
