一级创伤中心髋臼骨折的流行病学与治疗：对414例患者进行的10年回顾性研究

Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: Retrospective study of 414 patients over 10 years.

作者信息

Boudissa M, Francony F, Kerschbaumer G, Ruatti S, Milaire M, Merloz P, Tonetti J

机构信息

Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France; CNRS UMR 5525, laboratoire TIMC-IMAG, université Grenoble Alpes, Pavillon Taillefer, 38700 La Tronche, France.

Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.

出版信息

Orthop Traumatol Surg Res. 2017 May;103(3):335-339. doi: 10.1016/j.otsr.2017.01.004. Epub 2017 Feb 22.

DOI:10.1016/j.otsr.2017.01.004

PMID:28235575

Abstract

BACKGROUND

Epidemiological studies of acetabular fractures (AFs) are scarce and, to our knowledge, the most recent one from France, by Letournel and Judet, dates back to 1993. Studies have suggested a decrease in high-energy AFs contrasting with an increase in low-energy AFs due to the longer life expectancy. However, a French case-series study failed to confirm these data. We therefore conducted a 10-year retrospective study in a level-1 trauma centre to: (1) characterise the epidemiological profile of AF; (2) and to describe the treatment strategy.

HYPOTHESIS

The epidemiological profile of AF in France is consonant with data from European case-series studies.

METHOD

All patients managed for AF between 2005 and 2014 were included in this single-centre retrospective study. All patients were re-evaluated at our centre or another facility 6 months after the fracture. The epidemiological data were compared in the three treatment groups: non-operative, open reduction and internal fixation (ORIF), and total hip arthroplasty (THA).

RESULTS

Between 2005 and 2014, 414 patients were admitted for AF. Mean age was 49.4 years (range: 15-101 years). Treatment was non-operative in 231 (56%) older patients, most of whom had low-energy fractures involving the anterior wall. THA with or without acetabular reinforcement and screw-plate fixation was performed in 27 (7%) older patients, most of whom had posterior-wall fractures and experienced postoperative complications (26/27 patients, 96%). ORIF was used in 156 (38%) younger patients, most of whom had high-energy fractures of greater complexity.

CONCLUSION

Our results reflect the current indications in AF management. The epidemiological characteristics in our population are comparable to those reported in the few recent European epidemiological studies. To our knowledge, this is the largest French epidemiological study since the landmark work by Letournel and Judet.

LEVEL OF EVIDENCE

Level IV, retrospective study.

摘要

背景

髋臼骨折（AFs）的流行病学研究较少，据我们所知，法国Letournel和Judet进行的最新一项研究可追溯到1993年。研究表明，由于预期寿命延长，高能髋臼骨折数量减少，而低能髋臼骨折数量增加。然而，一项法国病例系列研究未能证实这些数据。因此，我们在一家一级创伤中心进行了一项为期10年的回顾性研究，目的是：（1）描述髋臼骨折的流行病学特征；（2）并描述治疗策略。

假设

法国髋臼骨折的流行病学特征与欧洲病例系列研究的数据一致。

方法

本单中心回顾性研究纳入了2005年至2014年间所有因髋臼骨折接受治疗的患者。所有患者在骨折后6个月在我们中心或其他机构进行了重新评估。对三个治疗组的流行病学数据进行了比较：非手术治疗、切开复位内固定术（ORIF）和全髋关节置换术（THA）。

结果

2005年至2014年间，414例患者因髋臼骨折入院。平均年龄为49.4岁（范围：15 - 101岁）。231例（56%）老年患者接受了非手术治疗，其中大多数为累及前壁的低能骨折。27例（7%）老年患者接受了带或不带髋臼强化和螺钉钢板固定的全髋关节置换术，其中大多数为后壁骨折且术后出现并发症（27例患者中的26例，96%）。156例（38%）年轻患者接受了切开复位内固定术，其中大多数为复杂性更高的高能骨折。