Huda Najmul, Islam Mir Shahid Ul, Bishnoi Sandeep, Utsav Kausamb
Department of Orthopaedic Surgery, Teerthankar Mahaveer University Moradabad, Uttar Pradesh, India.
Int J Burns Trauma. 2021 Apr 15;11(2):105-111. eCollection 2021.
To evaluate the impact of various factors on functional outcome of surgically managed displaced acetabular fractures.
In this prospective study 50 cases of surgically managed displaced acetabular fractures were followed up to a mean of 28.6±4 months (18-48 months). The effect of age, associated injuries, fracture pattern (elementary/associated type), time to surgery (<2 weeks/>2 weeks), accuracy of reduction (anatomical/imperfect/poor), gender and associated hip dislocation on the clinical outcome was evaluated using Harris hip score and modified Postel Merle d'Aubigné score.
The mean age was 36.6±11.9 years (range 19-67 years). There were 76% (n=38) males and 24% (n=12) females. 82% (n=41) patients sustained fracture due to motor vehicle accident. 60% of the cases had associated injuries. The mean Harris hip score at final follow-up was 80.96±8.9 and mean modified Merle d'Aubigné and Postel score was 15.1±2.4. The Harris Hip score and modified Postel Merle d'Aubigné score was significantly affected by presence of associated injuries (P=0.0025 and 0.0037 respectively), time to surgery (P=0.0087 and 0.0093 respectively), fracture pattern (P=0.015 and 0.023 respectively), associated hip dislocation (P=0.011 and 0.008 respectively), accuracy of reduction (P<0.05) and age (P<0.05), but gender (P=0.78 and 0.93 respectively) didn't have any significant effect on the clinical outcome.
The presence of associated injuries, concomitant hip dislocation, associated type of fracture patterns, elderly age (more than 60 years), sub optimal fracture reduction and delay in surgery beyond 2 weeks are factors that lead to statistically significant suboptimal functional scores.
评估各种因素对手术治疗移位髋臼骨折功能结局的影响。
在这项前瞻性研究中，对50例手术治疗的移位髋臼骨折患者进行了平均28.6±4个月（18 - 48个月）的随访。使用Harris髋关节评分和改良的Postel Merle d'Aubigné评分评估年龄、合并伤、骨折类型（基本型/复合型）、手术时间（<2周/>2周）、复位准确性（解剖复位/不完美复位/复位差）、性别及合并髋关节脱位对临床结局的影响。
平均年龄为36.6±11.9岁（范围19 - 67岁）。男性76%（n = 38），女性24%（n = 12）。82%（n = 41）的患者因机动车事故致伤。60%的病例有合并伤。末次随访时Harris髋关节平均评分为80.96±8.9，改良的Merle d'Aubigné和Postel平均评分为15.1±2.4。Harris髋关节评分和改良的Postel Merle d'Aubigné评分受合并伤（分别为P = 0.0025和0.0037）、手术时间（分别为P = 0.0087和0.0093）、骨折类型（分别为P = 0.015和0.023）、合并髋关节脱位（分别为P = 0.011和0.008）、复位准确性（P < 0.05）及年龄（P < 0.05）的显著影响，但性别（分别为P = 0.78和0.93）对临床结局无显著影响。
合并伤的存在、同时存在的髋关节脱位、骨折类型的复合型、老年（60岁以上）、骨折复位欠佳及手术延迟超过2周是导致功能评分在统计学上显著欠佳的因素。
