Operative Therapy Of 60 Cases With Acetabular Fractures One Clinic Outcome Study

Objective:To improve the clinical curative effect of acetabular fractures by summarizing the clinical cases and the surgical treatment of acetabular fractures,analyzing the timing of surgery.Methods:60 cases of acetabular fractures treated operatively from August 2005 to October 2007 were reviewed.A combined examination of X-ray,CT scanning and the thr ee-dimensional imaging of the spiral CT helps make an accurate diagnosis of acetabular fractures.All the cases were classified according to the Letournel-Judet classification and AO classification.Kocher-Langenbeck approach,illioinguinal approach and anteri combine d posterior approach were adopted for different fracture with reconstruction plates and sc rews.39 cases were treatead operatively within 2 weeks.54 cases of full informations wer e devided into within-2-week group and without-2-week group.The two groups were compared with excellent rate.P＜0.05 means significant difference through Chi-square test.Results:All the cases were followed up for average 17 months.According to criteria of Matta radiographicry reduction,there were 53 cases with anatomic reduction,6 wit h satisfactory reduction,1 with unsatisfactory reduction.Base on the modified d'AubigenEpstein clinical grading system,40cases(72.2%) showed excellent results,9(16.7%)good,5 (9.3%)fair,1(1.8%)poor.Heterotopic ossificati on was found in 3 cases(5%),traumatic arthrit is in 4 cases(6.7%).No avascular necrosis of femoral head.No death,infection or nonunion were found.The excellent rate is significant different between within-2-week group and without-2-week group through Chi-square test.Conclusions:Clinical analysis of the cases showed that surgery was a better option when the patients condition was good so that the fracture could almost achieve anatomical reduction.it suggests that the treatment should base on the type of the fracture.In the treatment,good reduction,rigid internal fixation and early functional recovery are essential.Much care,however,should be given to the selection of the operation approach,prevention of complications such as damage to the sciatic nerve,heterotopic ossification,venous thrombus and traumatic arthritis.Within two weeks of surgery will receive better treatment.