[Treatment of acetabular fractures]

The authors present an account of 85 patients with fractures of the acetabulum treated at the Orthopaedic Clinic, Faculty Hospital Plzen in 1985-1991. The fractures are classified according to Lettournel-Judet. The authors investigated associated injuries which prolong the interval between injury and operation as well as the correlation between the mechanism of injury and the patient's age and the incidence of injuries in different months of the year. For indication for operation the quality of reposition evaluated by computed tomography is essential. The authors analyze the length of the interval between injury and operation, administration of antibiotics and anticoagulants. As to early complications, they pay attention in particular to bronchopneumonia, infection and thromboembolic disease. The paper deals also with the most serious late complication--avascular necrosis--and the authors discuss the causes of its development as well as possibilities to influence it. The paper presents also results evaluating patients as regards their return to work, subjective evaluation of gait, pain of the joints and satisfaction with treatment. The case-history is followed by discussion concerned with the importance of computed tomography, the surgical approach, importance of treatment of the sacroiliac complex, the development of heterotopic and ectopic ossifications and the essential time of relief of the operated joint. In the conclusion the authors summarize the basic principles of fractures of the acetabulum.