비구 골절의 수술적 치료

Abstract

Purpose: To analyse clinical and radiological results of operative treatment of displaced acetabular fractures and establish the guideline for the operative treatment of displaced acetabular fracture with the analysis of the clinical and radiological results. Materials and Methods: A clinical analysis was performed on 51 patients with displaced acetabular fractures who had been operated on and followed for minimum 1 year period from January 1999 to December 2004. Clinical outcome was analyzed clinically by Postel's clinical grade criteria and radiologically by Matta’s roentgenographic grading system. Results: According to Letournel’s classification, we had 32 elementary fractures(63%) and 19 associated fracture(37%). Among the elementary fractures, the posterior wall fracture was the most common type(19 cases) and both column fracture was the most common type among associated fractures(8 cases). There were 34 Kocher-Langenbeck, 12 ilioinguinal and 5 other approaches. The mean duration of follow up after the operation was 45 months (range, 12 to 67 months). Among 51 patients, the satisfactory results were achieved in 44 cases (86%) on clinical grade and 41 cases (80%) on radiographic grade. The complications were developed in 9 cases out of 51 cases, including 2 cases of superficial infection, 1 case of deep vein thrombosis, 4 cases of posttraumatic arthritis and 2 cases of osteonecrosis of femoral head, Conclusion: In the results of this study, the satisfactory operative reduction of the fracture correlates with a satisfactory clinical result. Therefore in the surgical treatment of the acetabuluar fractures, it is essential to achieve an anatomical reduction and secure fixation by fully understanding the pathologic anatomy and choosing an appropriate approach and fixation devices.