Reahl G Bradley, McTague Michael F, Suneja Nishant, Weaver Michael J, Smith Malcolm, von Keudell Arvind G
Boston University School of Medicine, Boston, MA, USA.
Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA.
J Orthop. 2023 Jan 4;36:132-136. doi: 10.1016/j.jor.2023.01.001. eCollection 2023 Feb.
AIMS & OBJECTIVES: Our study sought to determine if posterior wall (PW) involvement in associated both-column acetabular fractures (ABCAFs) is associated with different clinical outcomes, primarily rate of conversion to total hip arthroplasty (THA), in comparison to ABCAFs with no PW involvement.
MATERIALS & METHODS: This retrospective observational cohort study was performed at two academic Level 1 trauma centers. Two study groups were identified. The first study group consisted of 18 patients who sustained an ABCAF with PW involvement (+PW). The second study group consisted of 26 patients who sustained an ABCAF with no PW involvement (-PW). All patients achieved a minimum 12-months of follow-up and/or received a THA conversion procedure at a time remote to their index open reduction internal fixation (ORIF) procedure. The primary outcome of this study was subsequent conversion to THA on the injured hip. The secondary outcome was the presence of post-operative pain at ≥6 months and/or complications.
No difference in rate of conversion to THA between + PW (n = 4, 22.2%) and -PW (n = 3, 11.5%) groups was demonstrated (p = 0.419). Similarly, no differences were seen between groups regarding complication rate (p = 0.814) and post-operative pain (p = 0.142).
Involvement of the PW does not appear to create worse clinical outcomes in comparison to no involvement in ABCAFs particularly as it relates to ipsilateral joint replacement.
我们的研究旨在确定与未累及后壁（PW）的双柱髋臼骨折（ABCAF）相比，累及后壁的ABCAF是否与不同的临床结果相关，主要是全髋关节置换术（THA）的转换率。
这项回顾性观察队列研究在两个一级学术创伤中心进行。确定了两个研究组。第一个研究组由18例累及后壁的ABCAF患者（+PW）组成。第二个研究组由26例未累及后壁的ABCAF患者（-PW）组成。所有患者至少随访12个月和/或在远离其初次切开复位内固定（ORIF）手术的时间接受THA转换手术。本研究的主要结果是受伤髋关节随后转换为THA。次要结果是术后≥6个月出现疼痛和/或并发症。
+PW组（n = 4，22.2%）和-PW组（n = 3，11.5%）之间THA转换率无差异（p = 0.419）。同样，两组之间在并发症发生率（p = 0.814）和术后疼痛方面也没有差异（p = 0.142）。
与未累及后壁的ABCAF相比，累及后壁似乎不会产生更差的临床结果，特别是在同侧关节置换方面。
