Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
Key Laboratory of Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
J Orthop Surg Res. 2022 May 13;17(1):264. doi: 10.1186/s13018-022-03148-8.
To describe and analyze the morphological characteristics, location and frequency of pure transverse acetabular fracture lines through fracture mapping and quantitative measurements.
Transverse fractures were retrospectively reviewed and analyzed. All computed tomography (CT) data were used for reconstruction and manual reduction. The reductive fracture fragments were graphically overlaid onto a three-dimensional (3D) right hemipelvis template. Then, the fracture lines were accurately depicted onto the surface of the 3D template. The fracture lines were overlapped onto the model to create the 3D fracture map and heatmap. All cases were subdivided into infratectal (62-B1.1), juxtatectal (62-B1.2), and transtectal (62-B1.3) types based on the AO Foundation/Orthopedic Trauma Association (AO/OTA) classification. Some anatomic parameters of the transverse fractures were also analyzed in these 3 groups.
Our study included forty-nine transverse fractures from 32 male and 17 female patients (mean age, 42 years; range 21-74 years) and included 19 type 62-B1.1, 17 type 62-B1.2, and 13 type 62-B1.3 fractures. The average anterior rim fracture angle was 70.0° (± 11.6°), and the posterior rim fracture angle was 92.4° (± 28.5°). The anterior rim fracture angles in 40 cases (40/49, 81.6%) fell within a wide range between 63° and 80°. On the heatmap, the hot zones were located on the highest position of the cotyloid fossa and the narrowed region, and the cold zone was on the inferior third of the articular surface. For type 62-B1.3 fractures, the hot zone was located on the posterior of the acetabular dome. There were no significant differences in anterior rim fracture angle and anterior height among the three patterns (P = 0.071, P = 0.072). Post hoc tests of the posterior rim fracture angle and the posterior height revealed significant differences among fracture subtypes (P < 0.01). The posterior intra-articular fracture line was significantly longer than the anterior intra-articular fracture line in type 62-B1.1 and type 62-B1.2 fractures (P < 0.01).
The fracture lines of transverse fractures through the anterior rim were concentrated on the narrowed zone, and the posterior fracture lines were diffusely distributed. The intra-articular fracture line distribution was focused on the superior and middle thirds of the joint surface. The recurrent fracture lines involving the weight-bearing dome mainly converged on the posterior region of the roof.
通过骨折图和定量测量，描述和分析纯横向髋臼骨折线的形态特征、位置和频率。
回顾性分析横向骨折。所有 CT 数据均用于重建和手动复位。将复位骨折碎片图形叠加到三维（3D）右半骨盆模板上。然后，将骨折线准确地描绘到 3D 模板表面。将骨折线叠加到模型上以创建 3D 骨折图和热图。所有病例均根据 AO 基金会/骨科创伤协会（AO/OTA）分类分为肛提肌下（62-B1.1）、肛提肌旁（62-B1.2）和经肛提肌（62-B1.3）型。还对这 3 组中的横向骨折的一些解剖参数进行了分析。
我们的研究包括 32 名男性和 17 名女性患者（平均年龄 42 岁；范围 21-74 岁）的 49 例横向骨折，包括 19 例 62-B1.1 型、17 例 62-B1.2 型和 13 例 62-B1.3 型骨折。前缘骨折角平均为 70.0°（±11.6°），后缘骨折角为 92.4°（±28.5°）。40 例（40/49，81.6%）的前缘骨折角在 63°至 80°之间的宽范围内。在热图上，热点位于髋臼窝的最高点和狭窄区域，冷区位于关节面的下三分之一。对于 62-B1.3 型骨折，热点位于髋臼穹顶的后部。三种类型的前缘骨折角和前高度无显著差异（P=0.071，P=0.072）。后缘骨折角和后高度的事后检验显示骨折亚型之间存在显著差异（P<0.01）。62-B1.1 型和 62-B1.2 型骨折的后关节内骨折线明显长于前关节内骨折线（P<0.01）。
前缘横向骨折线集中在狭窄区，后缘骨折线弥散分布。关节内骨折线分布集中在关节面的中上三分之一。负重穹顶的复发性骨折线主要集中在后部。
