Pantazopoulos T, Mousafiris C
University Department of Orthopaedics, K.A.T. Accident Hospital, Kifissia-Athens, Greece.
Clin Orthop Relat Res. 1989 Sep(246):57-64.
Surgical treatment is indicated in most displaced acetabular fractures in young adults. The fractures are generally intraarticular and almost invariably involve the weight-bearing area of the acetabulum. Complete or near anatomic reduction is essential for an excellent and long-standing recovery of the hip joint, and this is extremely difficult to accomplish by conservative management. Fifty-eight displaced central acetabular fractures treated surgically were followed from one to 12 years. They were evaluated by anteroposterior and oblique roentgenograms and classified according to the Judet-Letournel system. Although surgical treatment was somewhat delayed and the experience in approaching and dealing with these fractures was limited in many of the early cases, excellent or satisfactory reduction to a less than 3-mm displacement at the articular surface was achieved in 81% of cases. A close agreement was found between the quality of surgical reduction and clinical results as well as between roentgenographic and clinical results at the final follow-up examination, which were satisfactory in 72% and 74%, respectively. The surgical complications were infection in 2% of cases, peroneal nerve palsy in 8.5%, and moderate to severe ectopic ossification in 10% of the patients.
手术治疗适用于大多数年轻成人移位型髋臼骨折。这些骨折通常为关节内骨折，几乎总是累及髋臼的负重区。对于髋关节实现良好且持久的恢复而言，完全或近乎解剖复位至关重要，而通过保守治疗极难做到这一点。对58例接受手术治疗的移位型中央髋臼骨折患者进行了1至12年的随访。通过前后位和斜位X线片对其进行评估，并根据Judet-Letournel系统进行分类。尽管手术治疗有所延迟，且在许多早期病例中处理这些骨折的经验有限，但81%的病例实现了关节面移位小于3毫米的优秀或满意复位。在末次随访检查时，手术复位质量与临床结果之间以及X线检查结果与临床结果之间存在密切一致性，分别有72%和74%的结果令人满意。手术并发症包括2%的病例发生感染、8.5%的病例发生腓总神经麻痹以及10%的患者出现中度至重度异位骨化。
