Surgical treatment for complex acetabular fractures

摘要

Objective: To explore the effect of surgical treatment on complex acetabular fractures. Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8. Results: All the patients were followed up for 3. 5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86%. Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.