[髋臼骨折的外科治疗。长期结果]。

Acta ortopedica mexicana Pub Date : 2022-11-01
C Matellanes-Palacios, J Diranzo-García, V Estrems-Díaz, V Marquina-Moraleda, L Marco-Díaz, L Hernández-Ferrando
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引用次数: 0

摘要

引言:髋臼骨折占所有观察到的骨折的0.3%至0.6%,这些损伤相对较少。目的:评价在我院接受手术治疗的髋臼骨折患者的临床和放射学结果,最小随访时间为11.5年。次要目标是确定这些患者髋关节的失败率,并确定相关的风险因素。材料与方法:回顾性分析23例髋臼骨折采用开放复位内固定术(ORIF)治疗的临床资料。他们平均随访14年(范围11.5-17.5)。Judet y Letournel将骨折分为简单骨折或复杂骨折。临床和放射学结果采用Harris量表进行分析。结果:我们在Harris量表上获得了81.90/100的平均值,目的是与复杂骨折相比,简单骨折的疗效更好(p=0.027)。解剖复位的患者也获得了更高的分数(p=0.033)。三名患者需要翻修和放置全关节置换术(13%)。然而,体重指数(BMI)>30的患者往往会获得较差的临床结果(p=0.151)。结论:由于长期随访记录了良好的临床和放射学结果,因此可以建议对髋臼骨折进行ORIF治疗。复杂骨折、非解剖复位和BMI>30被确定为髋关节病进展的危险因素。
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[Surgical treatment of acetabular fractures. Long term outcomes].

Introduction: acetabular fractures constitute between 0.3 and 0.6% of all observed fractures, being these injuries relatively infrequent.

Objective: to evaluate clinical and radiological outcomes of surgical treatment of patients with acetabular fracture treated in our hospital with a minimal follow-up of 11.5 years. The secondary objective is to determine the rate of failure in the hip joint of these patients and establish risk factors that are involved.

Material and methods: 23 patients with acetabular fractures that were treated by open reduction and internal fixation (ORIF) were retrospectively analysed. They were follow-up during an average of 14 years (range 11.5-17.5). Fractures were classified by Judet y Letournel as simple or complex. Clinical and radiological outcomes were analysed by Harris scale.

Results: We obtained an average of 81.90/100 on the Harris scale, aiming at better outcomes on simple fractures compare to those that were complex (p = 0.027). Higher scores were also achieved on those patients with an anatomical reduction (p = 0.033). Three patients required revision and placement of a total arthoplasty (13%). However, patients with body mass index (BMI) > 30 tend to achieve poor clinical results (p = 0.151).

Conclusions: ORIF may be suggested for acetabular fractures since good clinical and radiological outcomes were recorded on a long-term follow-up. Complex fractures, non-anatomical reduction and BMI > 30 were identified as risk factors to coxarthrosis progression.

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