Operative treatment of displaced acetabular fractures / 中华创伤杂志

ABSTRACT

Objective To discuss operative treatment method for displaced acetabular fractures so as to improve the curative effects.Methods A retrospective study was done on data of 46 patients with displaced acetabular fractures treated operatively from June 2000 to September 2008.According to Letournel-Judet classification,there were eight patients with posterior column fractures combined with posterior walk fractures,four with anterior column fractures combined with posterior wall fractures,11 with transverse fractures combined with posterior wall fractures,eight with type T fractures and 15 with doublecolumn fractures.All patients were treated with open reduction and internal reconstructive plate fixation through Kocher-Langenbeck,iloinguinal or anteroposterior approaches respectively.Results All patients were followed up for 6 months to 8 years(average 3.9 years).According to modified Merle d' Aubigne and Postel score criteria,the result was excellent in 23 patients,good in 14,fair in 7 and poor in 2,with excellence rate of 80%.Postoperative complications included fat liquefaction in two patients(4%),iatrogenic sciatic nerve injury in two(4%),femoral head necrosis in three(7%),heterotopic ossification in three(7%)and traumatic arthritis in four(9%),with no operative death or nonunion occurred.Conclusions Preoperative accurate assessment of fracture type and displacement direction,appropriate selection of operation time and surgical approach as well as good operative reduction and internal fixation are key to providing satisfactory outcome for displaced acetabular fractures.