Skip to main content
Erschienen in: International Orthopaedics 9/2017

14.06.2017 | Original Paper

Surgical treatment of unstable pelvic fractures with concomitant acetabular fractures

verfasst von: Leyi Cai, Yiting Lou, Xiaoshan Guo, Jianshun Wang

Erschienen in: International Orthopaedics | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To explore the diagnosis, treatment, and clinical prognosis of patients with both unstable pelvic fractures and concomitant acetabular fractures.

Material and methods

We retrospectively analyzed 21 cases of unstable pelvic fractures with concomitant acetabular fractures treated between January 2013 and December 2014. All 21 patients (18 males, 3 females), aged 43.5–55 years (range: 21–55 years), underwent surgery within four to 15 days (average = 6.5 days) after injury. We evaluated the pre-operative diagnoses, surgical approaches, types of fixation used, and prognoses.

Results

All 21 patients were followed-up for six to 18 months. The quality of post-operative pelvic fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 12, and fair in four. The clinical outcomes at the final follow-up (scored using the Majeed criteria) were excellent in ten cases, good in eight, and fair in three. The quality of post-operative acetabular fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 11, and poor in five. Hip joint function was evaluated at the final follow-up (using the D’Aubigné scoring system) and was excellent in eight cases, good in nine, and fair in four. The healing time was 12–18 weeks for pelvic fractures and 12–22 weeks for acetabular fractures. Post-operative wound infections in two patients were controlled after second operations featuring debridement and irrigation. We found no instance of heterotopic ossification, ischemic necrosis of the femoral head, or iatrogenic vascular or nerve injury.

Conclusions

Good therapeutic outcomes in patients with unstable pelvic fractures and concomitant acetabular fractures can be achieved via accurate diagnosis, careful pre-operative planning, a well-performed operation, effective reduction and surgical fixation, and appropriate exercise to allow functional rehabilitation.
Literatur
1.
Zurück zum Zitat Karadimas EJ, Nicolson T, Kakagia DD et al (2011) Angiographic embolisation of pelvic ring injuries. Treatment algorithm and review of the literature. Int Orthop 35:1381–1390CrossRefPubMedPubMedCentral Karadimas EJ, Nicolson T, Kakagia DD et al (2011) Angiographic embolisation of pelvic ring injuries. Treatment algorithm and review of the literature. Int Orthop 35:1381–1390CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Halawi MJ (2016) Pelvic ring injuries: emergency assessment and management. J Clin Orthop Trauma 6:252–258CrossRef Halawi MJ (2016) Pelvic ring injuries: emergency assessment and management. J Clin Orthop Trauma 6:252–258CrossRef
3.
Zurück zum Zitat Poenaru DV, Popescu M, Anglitoiu B et al (2015) Emergency pelvic stabilization in patients with pelvic posttraumatic instability. Int Orthop 39:961–965CrossRefPubMed Poenaru DV, Popescu M, Anglitoiu B et al (2015) Emergency pelvic stabilization in patients with pelvic posttraumatic instability. Int Orthop 39:961–965CrossRefPubMed
4.
Zurück zum Zitat Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surge(Br) 70:1–12CrossRef Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surge(Br) 70:1–12CrossRef
5.
Zurück zum Zitat Letournel E (1980) Acetabulum fracture: classification and management. Clin Orthop 151:81–106 Letournel E (1980) Acetabulum fracture: classification and management. Clin Orthop 151:81–106
6.
Zurück zum Zitat Matta JM, Tornetta P (1996) Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res 329:129–140CrossRef Matta JM, Tornetta P (1996) Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res 329:129–140CrossRef
7.
Zurück zum Zitat Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg(Am) 78(11):1632–1645CrossRef Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg(Am) 78(11):1632–1645CrossRef
8.
Zurück zum Zitat Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg (Br) 71:304–306 Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg (Br) 71:304–306
9.
Zurück zum Zitat Gansslen A, Pohlemann T, Paul C et al (1996) Epidemiology of pelvic ring injuries. Injury 27(Suppl 1):SA13–SA20CrossRef Gansslen A, Pohlemann T, Paul C et al (1996) Epidemiology of pelvic ring injuries. Injury 27(Suppl 1):SA13–SA20CrossRef
10.
Zurück zum Zitat Vaidya R, Oliphant BW, Hudson I et al (2013) Sequential reduction and fixation for windswept pelvic ring injuries (LC3) corrects the deformity until healed. Int Orthop 37:1555–1560CrossRefPubMedPubMedCentral Vaidya R, Oliphant BW, Hudson I et al (2013) Sequential reduction and fixation for windswept pelvic ring injuries (LC3) corrects the deformity until healed. Int Orthop 37:1555–1560CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Vallier HA, Cureton BA, Ekstein C et al (2011) Early definitive stabilization of unstable pelvis and acetabulum fractures reduces morbidity. J Trauma 69:677–684CrossRef Vallier HA, Cureton BA, Ekstein C et al (2011) Early definitive stabilization of unstable pelvis and acetabulum fractures reduces morbidity. J Trauma 69:677–684CrossRef
12.
Zurück zum Zitat Takashi S, Wade RS, David JH et al (2010) Combined injuries of the pelvis and acetabulum: nature of a devastating dyad. J Orthop Trauma 24:303–308 Takashi S, Wade RS, David JH et al (2010) Combined injuries of the pelvis and acetabulum: nature of a devastating dyad. J Orthop Trauma 24:303–308
13.
Zurück zum Zitat Zhu S, Wang M, Wu X et al (2005) Operative treatment of compound acetabular fractures through single ilioinguinal approach. Chin J Orthop Trauma 7:1025–1027 Zhu S, Wang M, Wu X et al (2005) Operative treatment of compound acetabular fractures through single ilioinguinal approach. Chin J Orthop Trauma 7:1025–1027
14.
Zurück zum Zitat Matta JM (1994) Operative treatment of acetabular fractures through the ilioinguinal approach. A 10 -year perspective. Clin Orthop Relat Res 305:10–19CrossRef Matta JM (1994) Operative treatment of acetabular fractures through the ilioinguinal approach. A 10 -year perspective. Clin Orthop Relat Res 305:10–19CrossRef
Metadaten
Titel
Surgical treatment of unstable pelvic fractures with concomitant acetabular fractures
verfasst von
Leyi Cai
Yiting Lou
Xiaoshan Guo
Jianshun Wang
Publikationsdatum
14.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 9/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3532-0

Weitere Artikel der Ausgabe 9/2017

International Orthopaedics 9/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.