Hesp W L, Goris R J
Department of General Surgery, St. Radboud University Hospital, Nijmegen, The Netherlands.
Acta Chir Belg. 1988 Jan-Feb;88(1):27-32.
In a retrospective study the long-term results of conservative treatment of acetabular fractures has been evaluated. From 1967 through 1983, 79 patients with 81 fractures of the acetabulum were treated. The fractures were classified according to Judet and Letournel (1). Out of these 79 patients 83% had multiple injuries. The mean Injury Severity Score was 34 (9-75). Follow-up examination was performed in 55 patients. Partial avascular necrosis of the femoral head appeared in 11%. Fractures without dislocation had all a good prognosis. Fractures with dislocation, where the anterior column was involved, had a relative similar prognosis. In 79% of patients, where the dorsal column or roof of the acetabulum was involved, had a moderate or bad result. We conclude that no optimal result can be expected, when in dorsal column or acetabular roof fractures the reposition achieved by conservative treatment is insufficient. In these cases operative reposition and fixation should be considered.
在一项回顾性研究中，对髋臼骨折保守治疗的长期结果进行了评估。1967年至1983年期间，对79例患者的81处髋臼骨折进行了治疗。骨折根据朱代（Judet）和勒图尔内尔（Letournel）的方法进行分类（1）。在这79例患者中，83%有多处损伤。平均损伤严重度评分是34（9 - 75）。对55例患者进行了随访检查。股骨头部分缺血性坏死发生率为11%。无脱位的骨折预后均良好。涉及前柱的脱位骨折预后相对相似。在79%涉及髋臼后壁或髋臼顶的患者中，结果为中度或较差。我们得出结论，当髋臼后壁或髋臼顶骨折经保守治疗复位不充分时，无法预期获得最佳结果。在这些情况下，应考虑手术复位和固定。
