Department of Orthopedic Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Department of Orthopedic Surgery, Korean Armed Forces Capital Hospital, Gyeonggi-do, Republic of Korea.
Sci Rep. 2023 Nov 4;13(1):19091. doi: 10.1038/s41598-023-46652-5.
This study aimed to investigate the outcomes of elderly acetabular fractures according to the reduction of impacted dome fragments. A retrospective cohort study was performed in two institutions. Fifty-four patients aged ≥ 60 years with acetabular fractures were enrolled. Data for dome impaction and postoperative reduction was collected. Patients were divided into the good reduction group (displacement ≤ 3 mm) and poor reduction group (displacement > 3 mm). Postoperative osteoarthritis (OA), Harris hip score (HHS), total hip arthroplasty conversion, good/poor outcomes were compared between the two groups. The good reduction group (N = 45) demonstrated a lower proportion of radiographic OA (18 vs. 77%, P = 0.001), higher HHS (82.1 vs. 68.6, P = 0.022), and higher proportion of good outcomes than the poor reduction group (N = 9) (89 vs. 22%, P < 0.001). In a subgroup analysis of the patients with dome impaction, the good reduction group had a higher proportion of good outcomes (80 vs. 20%, P = 0.031). On comparing within the good reduction group, dome impaction did not influence clinical outcomes. Elderly acetabular fractures demonstrated favorable outcomes when adequate reduction was achieved even with dome impaction. Well-reduced dome impaction could achieve satisfactory outcomes in elderly acetabular fractures.
本研究旨在探讨根据髋臼顶部粉碎骨折复位情况评估老年髋臼骨折患者的预后。本研究采用回顾性队列研究，在两家机构进行。共纳入 54 例年龄≥60 岁的髋臼骨折患者。收集了顶部压陷和术后复位的数据。患者分为复位良好组（移位≤3mm）和复位不良组（移位＞3mm）。比较两组术后骨关节炎（OA）、Harris 髋关节评分（HHS）、全髋关节置换转换、优良/不良结局。复位良好组（N=45）的影像学 OA 比例较低（18%比 77%，P=0.001），HHS 较高（82.1 比 68.6，P=0.022），优良结局比例较高（89%比 22%，P＜0.001），优于复位不良组（N=9）。在顶部压陷患者的亚组分析中，复位良好组的优良结局比例更高（80%比 20%，P=0.031）。在复位良好组内比较，顶部压陷并不影响临床结局。即使存在顶部压陷，当达到充分复位时，老年髋臼骨折仍能获得良好的预后。良好复位的顶部压陷可使老年髋臼骨折获得满意的结果。
