Among these patients, one received a cemented total hip prosthesis. Results in fractures. Table 7 Associated bone lesions. In the study by Giannoudis et al 7the highest incidence was of fractures of the posterior column Of these ten cases, seven already presented lesions before the surgery; the other three presented neuropraxia, with full recovery at the last assessment. This distribution is not in agreement with what is found in the literaturein which type A fractures predominate.
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The aim of this study was to make a prospective acetwbulo in comparison with the literature, covering the type of access, fixation material, degree of reduction, type of fracture and results after surgery. Clinical outcome of surgical treatment. J Bone Joint Surg Am. Associated injuries were common and most of the fractures operated in our service came to us late. A prospective study of surgically treated acetabular fractures.
Today, high-kinetic energy trauma that is usually traffic-related predominates as the etiology 2. Only two of the variables analyzed, age and postoperative reduction, showed a statistically significant correlation with the collapse of the femoral head. The inclusion criteria were that these should be patients who underwent surgical treatment for fractures of the acetabulum, independent of whether there were any associated injuries; both sexes and all ages were included; and outpatient follow-up continued until February Thus, early intervention, a correct approach, good stabilization and reduction are important for minimizing the number of complications , In the second year return visits were scheduled semestrally, and annually after that.
The distribution of the types of access in relation to the types of fracture is shown in Table 6. For our cases, we used the Tile classification 6 because this is the one chosen in our service. The results found were compatible with those in the literature. J Bone Joint Surg Br. The following factors were acetanulo into account: The criterion for instability was hip misalignment associated with displacement of acetabu,o wall or the anterior or posterior column.
They also received venous antibiotic therapy first-generation cephalosporin starting from the perioperative period, consisting of two grams intravenously at the time of induction of anesthesia and a further two grams every six hours after the operation, for another 24 hours.
Incidence and a method of classification. The authors declare that there was no conflict of interest in conducting this work.
In our opinion, the general principles of treatment of articular fractures should be applied to the hip joint, even more so because it is a weight-bearing joint with a large range of motion. We excluded patients who underwent nonoperative treatment, those who did not have a minimum postoperative period of two years, or when they did not bring all the necessary information to our study. With the increasing number of high-energy traumas, caused mainly by car accidents, coupled with improvement in the rescue systems for polytraumatized patients, there has been an increase in the number of patients with acetabular fractures arriving at referral hospitals 1.
A review of the treatment of hip dislocations associated with acetabular fractures. Author information Copyright and License information Disclaimer. Cauchoix J, Truchet P. According to the Tile classification 6: Inclusion in quiz mode: Prognosis of fractures of the acetabulum. They note that if posttraumatic osteoarthritis develops in the presence of viable acetabular cartilage, it is primarily a result of altered distribution of pressure forces.
Fractures of the acetabulum. A major change took place starting inthanks to Letournel and Judet 3,4who greatly influenced the knowledge and systematization of this surgical treatment. Table 6 Side affected. One of the complications that appears early is the segmental collapse of the femoral head, referred to as joint wear by some authors and as necrosis by others 2,4,7, Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation.
Out of the cases initially assessed, only 73 were actually included in the analysis. The collapse of the femoral head acetagulo characterized by a loss of sphericity of the femoral head with flattening of the load-bearing area that is usually associated with sclerosis of the subchondral area Figure 3. Since then, surgical treatment, which had been only one of the options, has become the treatment of choice 4. Of these, records were analyzed. Case with hidden diagnosis. TOP Related.
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