Ruesch P D, Holdener H, Ciaramitaro M, Mast J W
Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, MI 48201.
Clin Orthop Relat Res. 1994 Aug(305):38-46.
Between November 1988 and March 1993, 101 patients with 102 fractures of the acetabulum were referred to the authors' institution. They included 31 both column; 25 transverse associated posterior wall; 16 anterior column associated posterior hemitransverse; 9 posterior wall; 7 posterior column associated posterior wall; 7 anterior column; 5 T shaped; and 2 transverse fractures. Thirteen fractures were excluded, leaving 89 patients with 89 operatively treated fractures available for followup. Postoperative radiographs were evaluated for adequacy of reduction and scored on a scale of 1-9 with 9 being perfect. Perfect or near perfect reduction was achieved in 82% of patients. A minimum of 1 year followup was available for 53 patients. Clinical results were assessed in terms of the patients' activities and included their ability to walk, range of motion and pain. Excellent results were achieved in 27 patients and an additional 16 had satisfactory results, for an overall 81% acceptable outcome. Radiographic evidence of posttraumatic osteoarthrosis was present in 40% of patients: mild in 10, moderate in 5, and severe in 5. Heterotopic ossification was Brooker Grade III and Grade IV in 1 patient each. These results indicate that operative treatment of acetabular fractures provides results that are superior to those achieved with nonoperative treatment.
1988年11月至1993年3月期间，101例髋臼骨折患者（共102处骨折）被转诊至作者所在机构。其中包括31例双柱骨折；25例横形骨折合并后壁骨折；16例前柱骨折合并后半横行骨折；9例后壁骨折；7例后柱骨折合并后壁骨折；7例前柱骨折；5例T形骨折；以及2例横行骨折。13例骨折被排除，剩余89例患者（89处接受手术治疗的骨折）可供随访。对术后X线片进行复位质量评估，并按1 - 9分进行评分，9分为完美复位。82%的患者实现了完美或接近完美的复位。53例患者获得了至少1年的随访。根据患者的活动情况评估临床结果，包括行走能力、活动范围和疼痛情况。27例患者结果优秀，另有16例结果满意，总体可接受率为81%。40%的患者有创伤后骨关节炎的影像学证据：轻度10例，中度5例，重度5例。异位骨化分别有1例为布鲁克（Brooker）Ⅲ级和Ⅳ级。这些结果表明，髋臼骨折的手术治疗效果优于非手术治疗。
