Stevens Jarrad M, Shiels Sarah, Whitehouse Michael R, Ward Anthony J, Chesser Tim J, Acharya Mehool
Department of Trauma and Orthopaedics, Southmead Hospital Bristol, BS10 5NB, United Kingdom.
St Vincent's Hospital Melbourne, Australia.
J Orthop. 2019 Nov 6;18:28-31. doi: 10.1016/j.jor.2019.10.012. eCollection 2020 Mar-Apr.
Acetabular fractures are uncommon and their management is often reserved for specialist pelvic and acetabular surgeons. Bilateral acetabular fractures are a particularly rare subgroup. We report the incidence, fracture pattern, mechanism of injury and outcome of patients presenting to a tertiary trauma centre with traumatic bilateral acetabular fractures.
Bilateral acetabular fractures were identified from a prospective database of acetabular fractures presenting to one institution over a six-year period. Patient notes and imaging studies were reviewed to identify demographics, mechanism of injury, Injury Severity Score, fracture pattern and management. Timing of operative management was explored. Patient outcomes were collected in the form of radiographs and Oxford Hip Scores at a minimum of one-year post injury.
Eight patients with bilateral acetabular fracture were identified from a database which contained records of 519 patients with acetabular fractures (incidence of 1.5% amongst patients with acetabular fractures). Motor vehicle accidents were the most common mechanism. Four acetabular fracture patterns were observed within the cohort. Radiographic union occurred in all cases and Oxford Hip Scores are suggestive of moderate to well functioning hip joints. Fractures were treated as single or staged procedures.
Bilateral acetabular fractures are very rare due to the unique degree and pattern of force required to fracture both acetabula. They are associated with 4 main fracture patterns and present with Injury Severity Scores that averaged 25 (severe). They are typically observed in young males with road traffic collision being the most common mechanism of injury.
髋臼骨折并不常见，其治疗通常由骨盆和髋臼专科外科医生负责。双侧髋臼骨折是一个极为罕见的亚组。我们报告了在一家三级创伤中心就诊的创伤性双侧髋臼骨折患者的发病率、骨折类型、损伤机制及治疗结果。
从一个前瞻性数据库中识别出在六年期间内到某一机构就诊的双侧髋臼骨折患者。回顾患者病历和影像学研究，以确定人口统计学特征、损伤机制、损伤严重程度评分、骨折类型及治疗方式。探讨手术治疗的时机。在受伤至少一年后，以X线片和牛津髋关节评分的形式收集患者的治疗结果。
从一个包含519例髋臼骨折患者记录的数据库中识别出8例双侧髋臼骨折患者（在髋臼骨折患者中的发病率为1.5%）。机动车事故是最常见的损伤机制。在该队列中观察到四种髋臼骨折类型。所有病例均实现影像学愈合，牛津髋关节评分提示髋关节功能为中度至良好。骨折采用单次或分期手术治疗。
由于双侧髋臼骨折所需的独特外力程度和类型，双侧髋臼骨折非常罕见。它们与4种主要骨折类型相关，损伤严重程度评分平均为25分（重度）。它们通常见于年轻男性，道路交通事故是最常见的损伤机制。
