Olson S A, Matta J M
Fellow Orthopaedic Institute, Hospital of the Good Samaritan, Los Angeles, California.
J Orthop Trauma. 1993;7(5):402-13. doi: 10.1097/00005131-199310000-00002.
The criteria to treat acetabular fractures operatively versus nonoperatively continue to evolve. The technique of roof arc measurements was developed to identify the extent of superior acetabulum left intact after fracture. Computerized tomography (CT) of the superior 10 mm of the acetabular articular surface evaluates the area equivalent to roof arc measurements of 45 degrees. CT provides increased detail of the superior acetabulum involved with the fracture. Our current criteria for selecting cases for nonoperative treatment are as follows: 1. The acetabular articular surface is intact in the superior 10 mm of the joint on CT evaluation. (Fractures that enter the acetabular fossa, but not the articular surface in the superior 10 mm are included in this group.) 2. The femoral head remains congruent with the superior acetabulum out of traction on the anteroposterior and 45 degree oblique radiographic views of the pelvis. 3. When a posterior wall fracture is part of the injury pattern, a minimum of 50% of the posterior wall articular surface is intact at the most involved level as determined by CT.
手术治疗与非手术治疗髋臼骨折的标准一直在不断发展。髋臼顶弧测量技术的开发是为了确定骨折后髋臼上方仍保持完整的范围。对髋臼关节面上方10毫米进行计算机断层扫描（CT）可评估相当于45度顶弧测量的区域。CT能提供更多有关骨折累及的髋臼上方的细节。我们目前选择非手术治疗病例的标准如下：1. CT评估显示关节上方10毫米处的髋臼关节面完整。（进入髋臼窝但未累及上方10毫米关节面的骨折包括在这一组中。）2. 在骨盆前后位和45度斜位X线片上，股骨头在牵引解除后与髋臼上方保持一致。3. 当后壁骨折是损伤模式的一部分时，根据CT确定，在最受累水平，后壁关节面至少50%完整。
