Moed B R, Letournel E
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689.
J Bone Joint Surg Br. 1994 Nov;76(6):895-900.
From 1987 to 1991, we treated 53 patients with 54 fractures of the acetabulum by reconstruction through a posterior or an extended iliofemoral surgical approach. For prophylaxis against heterotopic ossification we used perioperative irradiation and indomethacin. Indomethacin was given as daily doses of 25 mg started within 24 hours of operation and continued for four weeks. Irradiation was by either 1200 cGy in three daily doses or by a single 700 cGy dose on the first postoperative day. All patients were followed for at least one year postoperatively and the severity of heterotopic ossification was recorded using the Brooker classification and correlated with hip mobility. The combination therapy proved very effective; 44 fractures showed no heterotopic ossification and ten showed Brooker class I. The functional results were good and there were no complications of this therapy. Irradiation with 1200 cGy did not appear to offer any therapeutic advantage over the 700 cGy dose.
1987年至1991年期间，我们采用后路或扩大髂股手术入路重建的方法，治疗了53例髋臼骨折患者的54处骨折。为预防异位骨化，我们采用了围手术期放疗和吲哚美辛。吲哚美辛在术后24小时内开始每日服用25毫克，并持续四周。放疗采用每日三次共1200厘戈瑞的剂量，或在术后第一天单次给予700厘戈瑞的剂量。所有患者术后均随访至少一年，使用布鲁克分类法记录异位骨化的严重程度，并与髋关节活动度相关联。联合治疗证明非常有效；44处骨折未出现异位骨化，10处为布鲁克I级。功能结果良好，且该治疗无并发症。1200厘戈瑞的放疗剂量似乎并不比700厘戈瑞的剂量具有任何治疗优势。
