Hanyang University Guri Hospital, Hanyang University, Guri, Republic of Korea.
Kyungpook National Hospital, Kyungpook National University, Daegu, Republic of Korea.
J Orthop Sci. 2023 Mar;28(2):376-379. doi: 10.1016/j.jos.2021.12.004. Epub 2021 Dec 28.
This study aimed to determine characteristics of acetabular fractures in the elderly by evaluating clinical course and computed tomography-based radiological features between low- and high-energy acetabular fractures.
We reviewed 178 consecutive patients with acetabular fractures aged ≥60 years from six centers. Low-energy fractures (group 1) were identified in 23 (12.9%) patients and high-energy fractures (group 2) in 155 (87.1%) patients. We compared demographics, radiological findings, and clinical course between the groups.
Average age (70.6 vs. 67.8 years, p = 0.046) and ratio of females (47.8% vs. 23.2%, p = 0.021) were significantly higher in group 1 than in group 2. The Charlson comorbidity index was also higher in group 1, but no other demographics showed difference. More patients in group 2 than in group 1 underwent surgery (91.6% vs. 73.9%); however, more in group 1 underwent minimally invasive surgery (17.4% vs 4.5%). Anterior column-associated fracture patterns occurred in 91.4% and 38.7% of cases in groups 1 and 2, respectively. Most fractures were displaced (>2 mm); 68% of which were comminuted. Furthermore, 24.2% of the fractures had superior dome impaction, whereas 23.0% were associated with posterior wall impaction.
Patients who sustained low-energy acetabular fractures were mostly women, were older, and had more comorbidities. Radiological findings of low-energy acetabular fractures showed anterior column involvement associated with injury to the quadrilateral surface. Additionally, it was observed to be commonly combined with comminution and impacted fragments.
本研究旨在通过评估低能和高能髋臼骨折的临床过程和基于计算机断层扫描的影像学特征，确定老年髋臼骨折的特征。
我们回顾了来自六个中心的 178 例年龄≥60 岁的髋臼骨折连续患者。低能骨折（组 1）患者 23 例（12.9%），高能骨折（组 2）患者 155 例（87.1%）。我们比较了两组的人口统计学、影像学发现和临床过程。
组 1 的平均年龄（70.6 岁 vs. 67.8 岁，p=0.046）和女性比例（47.8% vs. 23.2%，p=0.021）明显高于组 2。组 1 的 Charlson 合并症指数也较高，但其他人口统计学数据无差异。组 2 比组 1 更多的患者接受了手术（91.6% vs. 73.9%）；然而，组 1 中有更多的患者接受了微创手术（17.4% vs. 4.5%）。组 1 和组 2 中前柱相关骨折模式分别发生在 91.4%和 38.7%的病例中。大多数骨折均有移位（>2mm）；其中 68%为粉碎性骨折。此外，24.2%的骨折存在顶骨上区撞击，而 23.0%与后壁撞击有关。
低能髋臼骨折患者主要为女性，年龄较大，合并症较多。低能髋臼骨折的影像学表现为前柱受累，伴有四边形面损伤。此外，还常伴有粉碎和嵌入碎片。
