Shon Hyun-Chul, Lim Eic-Ju, Yang Jae-Young, Min Chan-Hong
Department of Orthopedics, Chungbuk National University Hospital, Cheongju, Korea.
Clin Orthop Surg. 2024 Dec;16(6):871-879. doi: 10.4055/cios23359. Epub 2024 Oct 11.
Acetabular fractures are rare and challenging to treat, and the surgeon's learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies. Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, single-center studies. According to the authors' literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year.
This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta's quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta's radiological outcome grading and the modified Postel Merle d'Aubigné score were confirmed as radiological and functional outcomes, respectively.
The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age ( = 0.009), quality of reduction ( < 0.001), and the Judet and Letournel classification ( = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction ( < 0.001) and the Judet and Letournel classification ( = 0.030).
Our radiological and functional outcomes of acetabular fractures were comparable with those of other single-surgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.
髋臼骨折较为罕见且治疗具有挑战性,外科医生处理这些骨折的学习曲线很陡。髋臼骨折的发病率较低,使得开展单外科医生、单中心研究很困难。因此,与单外科医生、单中心研究相比,多外科医生和多中心研究可能会产生不一致的结果。根据作者的文献调查,缺乏关于此主题的单外科医生、单中心、大规模研究。因此,本研究调查了在单中心由单外科医生治疗且随访至少1年的移位髋臼骨折患者的放射学和功能结果以及预后因素。
本回顾性研究对2005年1月至2021年12月期间在忠北国立大学医院接受髋臼骨折治疗的149例患者进行。使用病历收集人口统计学数据、手术时间和并发症。术前X线片确定Judet和Letournel分类,术后即刻X线片确定Matta复位质量。在最近的门诊随访中,Matta放射学结果分级和改良的Postel Merle d'Aubigné评分分别被确定为放射学和功能结果。
131例患者(87.9%)的放射学结果为优或良,18例(12.1%)为中或差,且受年龄(P = 0.009)、复位质量(P < 0.001)和Judet及Letournel分类(P = 0.025)影响。121例患者(81.2%)的功能结果为优或良,28例(18.8%)为中或差;这受复位质量(P < 0.001)和Judet及Letournel分类(P = 0.030)影响。
就随访期而言,我们的髋臼骨折放射学和功能结果与其他单外科医生、单中心研究的结果相当。放射学结果的不良预后因素包括年龄>65岁、相关类型以及复位质量差。相关类型和复位质量差是与功能结果不佳相关的因素。