Diagnosis and treatment of acetabular fractures of AO Type C / 中华创伤骨科杂志

ABSTRACT

Objective To discuss the timing and methods of operative treatment of acetabular fractures of AO Type C (double- column fractures). Methods From February, 1999 to January, 2004, we treated operatively 46 cases of AO Type C acetabular fractures, including 23 cases of C- 1 type, 14 cases of C- 2 type, and 9 cases of C- 3 type. 15 cases were treated through ilioinguinal approach, 10 cases through improved Kocher- Langenbeck approach, and 21 cases through combined anterior and posterior approaches. There were 3 groups of patients according to the time from injury to operation 15 cases got operation within 1st week after injury (Group A); 23 cases within 2nd week (Group B); 8 cases within/after 3rd week (Group C). All of them were checked with radiography and 3D CT scan before and after operation. Results 34 cases( 73.9% ) obtained anatomical reduction, 8 cases( 17.4% ) got imperfect reduction, and 4 cases( 8.7% ) had unsatisfactory reduction. All the patients were followed up for 1 year to 4 years, averaging 31 months. According to D' Aubigne and Postel Hip Score, joint function was rated as excellent in 32 cases( 69.6% ) , good in 5 cases( 10.9% ) , fair in 5 cases ( 10.9% ) and poor in 4 cases ( 8.7% ) . As far as reduction was concerned, there was a significant difference (P0.05). As far as joint function was concerned, there was a significant amelioration in Groups A and B compared with Group C (P0.05) between group A and Group B. Conclusions Good knowledge of AO classification of acetabular fractures combined with particular radiological data can result in correct diagnosis of Type C acetabular fractures. Operations should be carried out within 2 weeks after injury and efforts should be made to ensure anatomical reduction. To achieve good clinical results in treatment of Type C acetabular fractures, suitable approaches and correct reduction and internal methods are essential