Moed Berton R, Kregor Philip J, Reilly Mark C, Stover Michael D
Professor and Chairman, Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, Missouri.
Instr Course Lect. 2017 Feb 15;66:3-24.
The main goals of acetabular fracture management are to restore the congruity and stability of the hip joint. These goals are the same for all patients who have an acetabular fracture, regardless of the morphology or etiology of the fracture. Nevertheless, certain acetabular fracture types and several patient factors pose management challenges for surgeons. Therefore, surgeons who manage acetabular fractures must understand the distinctive features of acetabular fractures as well as the soft-tissue and patient-related factors that play a critical role in patient outcomes. Particular challenges in the management of acetabular fractures include acetabular fracture types that involve the posterior wall, acetabular fractures with soft-tissue concerns, acetabular fractures in patients with multiple injuries, and acetabular fractures in the geriatric population. Although the well-known protocols that were established by Judet and Letournel continue to be important guidelines for the management of acetabular fractures, the injury characteristics of acetabular fractures, the demographics of the patients in whom acetabular fractures occur, and the treatment options for acetabular fractures have evolved. Therefore, surgeons must be aware of new and more recently published information on acetabular fractures.
髋臼骨折治疗的主要目标是恢复髋关节的完整性和稳定性。对于所有髋臼骨折患者而言,无论骨折的形态或病因如何,这些目标都是相同的。然而,某些髋臼骨折类型以及一些患者因素给外科医生带来了治疗挑战。因此,处理髋臼骨折的外科医生必须了解髋臼骨折的独特特征以及在患者预后中起关键作用的软组织和患者相关因素。髋臼骨折治疗中的特殊挑战包括累及后壁的髋臼骨折类型、伴有软组织问题的髋臼骨折、多发伤患者的髋臼骨折以及老年人群的髋臼骨折。尽管Judet和Letournel制定的著名方案仍然是髋臼骨折治疗的重要指导原则,但髋臼骨折的损伤特征、发生髋臼骨折患者的人口统计学特征以及髋臼骨折的治疗选择都已发生了变化。因此,外科医生必须了解有关髋臼骨折的最新和最近发表的信息。