Giordano Vincenzo, Acharya Mehool R, Pires Robinson Esteves, Giannoudis Peter V
Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil.
Clínica São Vicente, Rede D'or São Luiz, Rio de Janeiro, RJ, Brazil.
J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1031-1038. doi: 10.1016/j.jcot.2020.08.027. Epub 2020 Sep 12.
The management of both-column fractures of the acetabulum is challenging for the orthopaedic surgeon. Operative treatment is usually recommended in this particular fracture pattern, as residual joint surface displacement has been shown to increase local contact stress, drastically leading to rapid cartilage destruction. In this review, we present an overview of operative steps and surgical technique for both-column acetabular fracture reconstruction. Therefore, we demonstrate how correct understanding of fracture morphology and displacement, preoperative preparation, including choice of approach and patient positioning, reduction strategies, and programmed sequential fixation, starting from superior fracture lines on the anterior acetabular column and ending on the posterior components of this fracture type, may provide satisfactory outcomes in this difficult acetabular fracture pattern.
髋臼双柱骨折的治疗对骨科医生来说具有挑战性。对于这种特殊的骨折类型，通常建议进行手术治疗，因为已表明残余关节面移位会增加局部接触应力，从而急剧导致软骨快速破坏。在本综述中，我们概述了髋臼双柱骨折重建的手术步骤和手术技术。因此，我们展示了如何正确理解骨折形态和移位、术前准备（包括入路选择和患者体位）、复位策略以及程序化的顺序固定（从髋臼前柱的上方骨折线开始，到这种骨折类型的后部组件结束），可能会在这种困难的髋臼骨折类型中提供令人满意的结果。
