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[Operative treatment of acetabular fractures]
1Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035.
Objective:
To improve the level of the management of complicated acetabular fracture.
Methods:
56 acetabular fractures were treated operatively from March 1993 to May 1998. According to Letournel-Judet classification, 7 cases were posterior wall fracture, 6 posterior column fracture, 4 anterior column fracture, 6 transverse fracture, 6 T-shaped fracture, 10 posterior column combined posterior wall fracture, 6 transverse combined posterior wall fracture, 2 anterior combined posterior hemi-transverse fracture and 6 both column fracture. Kocher-Langebeck approach, illioinguinal approach, illiofemoral approach, extended illiofemoral approach and anterior combined posterior approach were adopted for different fractures with reconstruction plates and screws.
Results:
49 of 56 cases were followed up on an average of 26.4 months. According to Matta's evaluation, 19 cases (39%) showed excellent results, 24 (49%) good, 4 (8%) fair, and 2 (4%) poor. Avascular necrosis of the femoral head was found in 4 cases (8%) and heterotopic ossification in 15 cases (30.6%). No death and infection were found in this series.
Conclusions:
According to our experience, accurate analysis of fractures preoperatively, reasonable surgical approaches and timing of surgery are essential to good treatment of acetabular fractures.