The Study Of The Outcomes In Acetabular Fractures And Complications

Objective:Retrospective study of71cases of surgical treatment of acetabular fractures, analysis of the factors that affect the efficacy and the prevention of complications.Methods:From Mar.2008to Jun.2012,71cases of acetabular fractures were reviewed in Xiangya Hospital of Central South University that included59male and12female patients. The average age of cases were44.6years (range from16to75years),age greater than or equal to40years old of48patients, younger than40years of23patients.63cases of patients with associated injuries,16patients with ipsilateral lower extremity fractures. According to Letournel-Judet classification system, simple fractures in26cases,45cases of complex fractures.Patients through outpatient and telephone follow-up, efficacy score with modified Merle d’Aubign E and Postel scoring criteria, In accordance with the clinical efficacy divided into:excellent, good, fair, poor. According to the timing of surgery, the quality of reduction, age, gender, type of fracture, with ipsilateral fractures of low limb, concurrent HO six factors grouped induction, score for each group follow-up results and calculate the excellent rate,and above for statistical analysis. Result:Surgery98patients,71patients were followed up, to8-63months of follow-up time, an average of21months. in accordance with the modified Merle d’Aubigne and Postel clinical effect scoring system, excellent in39cases, good in16cases, fair in11cases, poor in5cases, clinical excellent rate of77.47%.The excellent and good rate of fresh fracture and old fracture was84.61%,57.90%. the excellent and good rate of anatomical reduction and general+poor reduction cwas86%、57.14%. the excellent and good rate of age≥40years and age<40years was75%、82.61%. the excellent and good rate of male and female was79.66%、66.67%. the excellent and good rate of simple fracture and complex fracture was76.92%、77.78%. the excellent and good rate of with ipsilateral fractures of low limb and none was43.75%、87.27%. the excellent and good rate of postoperative HO and none was52.94%、85.19. Statistical results, fresh fractures and old fractures、anatomical reduction and general+poor reduction、with ipsilateral fractures of low limb and none、postoperative HO and none, have a significant difference; Age≥40years and age<40years、male and female、simple fractures and complex fractures,no significant difference.Complications:Postoperative infection in1case.Post-traumatic sciatic nerve injury in9cases,4cases of iatrogenic sciatic nerve injury.12cases of traumatic arthritis. Heterotopic ossification of the17cases, the Brooker classification Brooker Ⅰ Ⅱ13cases, Ⅲ Ⅳ grade four cases.Conclusion:(1)The Opportunity of surgery and quality of reduction are two key factors to improve the clinical efficacy.(2)Age, sex and the type of fracture is not an important factor affecting the clinical effiecy.(3) With ipsilateral fractures of low limb is a risk factor affecting the clinical efficacy of acetabular fracture.(4)postoperative heterotopic ossification is a risk factor affecting the clinical efficacy of acetabular fracture.(5)For posterior wall of large bone defects can not be repaired, available with muscle flap of the intertrochanteric crest with gluteus medius reconstruction.