School of Medicine, Duke University, Durham, NC, USA; Duke University Hospital, 40 Duke Medicine Circle, Durham, NC 27710, USA.
Division of Orthopedic Surgery, Duke University, Durham, NC, USA.
Orthop Clin North Am. 2024 Jan;55(1):9-17. doi: 10.1016/j.ocl.2023.06.009. Epub 2023 Aug 5.
Intraoperative fractures of the acetabulum are a rare but serious complication during total hip arthroplasty. Acute fractures generally require attention with plating, whereas chronic acetabular fractures may be approached with distraction, a Burch-Schneider cage, or a custom implant. It is imperative for arthroplasty surgeons to possess a thorough understanding of how to identify and manage these injuries. Collaborating with an orthopedic traumatologist for assistance with plating the anterior or posterior column, if necessary, can be invaluable. Management options encompass conservative management, revision style acetabular component, screw/plating of anterior/posterior column, and the use of a larger cup with multiple screw augmentation options.
髋关节置换术中髋臼骨折是一种罕见但严重的并发症。急性骨折通常需要用钢板固定,而慢性髋臼骨折可以采用牵引、Burch-Schneider 笼或定制植入物治疗。关节置换外科医生必须彻底了解如何识别和处理这些损伤。如果需要,与骨科创伤专家合作,协助进行前柱或后柱的钢板固定,这可能是非常宝贵的。治疗选择包括保守治疗、翻修型髋臼组件、前后柱螺钉/钢板固定以及使用更大的髋臼杯并增加多个螺钉固定选项。