Analysis of Predictors of Results after Surgical Treatment of Acetabular Fractures
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to analyze the factors affecting the outcomes after surgical treatment of acetabular fractures. Materials and Methods: Between January 2000 and December 2012, 106 patients with acetabular fractures were treated with open reduction and internal fixation. We performed a retrospective cohort study to analyze the factors which may influence a patient’s prognosis after surgical treatment of an acetabular fracture. The factors examined included age, femoral head injury, fracture type, dislocation, initial displacement, delay to injuryrelated surgery (in days), and quality of reduction. Additionally, we investigated clinical and radiological outcomes, as well as the development of osteoarthritis. Results: Patients included 85 males (80.2%) and 21 females (18.8%) with a mean age of 50.4 (17-78) years. The mean follow-up period was 2.6 (1-10) years. In a univariable regression analysis, quality of reduction, age, and initial displacement were significantly associated with radiological and clinical outcomes. In a multivariable regression analysis, quality of reduction (P<0.001) and initial displacement (P=0.001) were found to be factors predictive of clinical and radiological outcomes. Additionally, the quality of reduction (P=0.005) was found to be predictive of osteoarthritis development. Conclusion: Study results indicated that the quality of reduction was the most important factor influencing the prognosis of patients with acetabular fractures.
Abstract
Purpose: The aim of this study was to analyze the factors affecting the outcomes after surgical treatment of acetabular fractures. Materials and Methods: Between January 2000 and December 2012, 106 patients with acetabular fractures were treated with open reduction and internal fixation. We performed a retrospective cohort study to analyze the factors which may influence a patient’s prognosis after surgical treatment of an acetabular fracture. The factors examined included age, femoral head injury, fracture type, dislocation, initial displacement, delay to injuryrelated surgery (in days), and quality of reduction. Additionally, we investigated clinical and radiological outcomes, as well as the development of osteoarthritis. Results: Patients included 85 males (80.2%) and 21 females (18.8%) with a mean age of 50.4 (17-78) years. The mean follow-up period was 2.6 (1-10) years. In a univariable regression analysis, quality of reduction, age, and initial displacement were significantly associated with radiological and clinical outcomes. In a multivariable regression analysis, quality of reduction (P<0.001) and initial displacement (P=0.001) were found to be factors predictive of clinical and radiological outcomes. Additionally, the quality of reduction (P=0.005) was found to be predictive of osteoarthritis development. Conclusion: Study results indicated that the quality of reduction was the most important factor influencing the prognosis of patients with acetabular fractures.
참고문헌 (25)
- Chiu FY, "Surgical treatment of displaced acetabular fractures-72 cases followed for 10(6-14)years", Injury, 31, pp.181~185 (2000)
- Deo SD, "Operative management of acetabular fractures in Oxford", Injury, 32, pp.581~586 (2001)
- Liebergall M, "Acetabular fractures. Clinical outcome of surgical treatment", Clin Orthop Relat Res, (366), pp.205~216 (1999)
- Mayo KA, "Martimbeau CL. Surgical revision of malreduced acetabular fractures", Clin Orthop Relat Res, (305), pp.47~52 (1994)
- Stöckle U, "Treatment of complex acetabular fractures through a modified extended iliofemoral approach", J Orthop Trauma, 16, pp.220~230 (2002)
- Routt ML Jr, "Operative treatment of complex acetabular fractures. Combined anterior and posterior exposures during the same procedure", J Bone Joint Surg Am, 72, pp.897~904 (1990)
- Letournel E, "Acetabular fractures: classification and management", Clin Orthop Relat Res, (151), pp.81~106 (1980)
- Ferguson TA, "Fractures of the acetabulum in patients aged 60 years and older : an epidemiological and radiological study", J Bone Joint Surg Br, 92, pp.250~257 (2010)
- Brueton RN, "A review of 40 acetabular fractures : the importance of early surgery", Injury, 24, pp.171~174 (1993)
- Madhu R, "The time dependent effect of delay", J Bone Joint Surg Br, 88, pp.1197~1203 (2006)
- Matta JM, "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, pp.1632~1645 (1996)
- Mears DC, "Displaced acetabular fractures managed operatively: indicators of outcome", Clin Orthop Relat Res, (407), pp.173~186 (2003)
- Matta JM, "Fractures of the acetabulum. Early results of a prospective study", Clin Orthop Relat Res, (205), pp.241~250 (1986)
- Moed BR, "Functional outcomes of acetabular fractures", J Bone Joint Surg Am, 85(A), pp.1879~1883 (2003)
- Murray MM, "The death of articular chondrocytes after intra-articular fracture in humans", J Trauma, 56, pp.128~131 (2004)
- Petrisor BA, "Improving reliability in the classification of fractures of the acetabulum", Arch Orthop Trauma Surg, 123, pp.228~233 (2003)
- Judet R, "Fractures of the acetabulum:Classification and surgical approaches for open reduction", Preliminary report. J Bone Joint Surg Am, 46, pp.1615~1646 (1964)
- Meena UK, "Predictors of postoperative outcome for acetabular fractures", Orthop Traumatol Surg Res, 99, pp.929~935 (2013)
- Murphy D, "Prognostic factors and their inter-relationships", Injury, 34, pp.512~517 (2003)
- Bhandari M, "Predictors of clinical and radiological outcome in patients with fractures of the acetabulum and concomitant posterior dislocation of the hip", J Bone Joint Surg Br, 88, pp.1618~1624 (2006)
- 김원유, "비구골절의 치료", Hip and Pelvis, 22(2), pp.116~121 (2010), 대한고관절학회
- 강철형, "양지주 비구골절에서 장서혜 도달법을 이용한 후방 골주의 간접 정복", Hip and Pelvis, 21(4), pp.334~338 (2009), 대한고관절학회
- Isaacson MJ, "Treatment of acetabulum fractures through the modified Stoppa approach : strategies and outcomes", Clin Orthop Relat Res, 472, pp.3345~3352 (2014)
- Visutipol B, "Evaluation of Letournel and Judet classification of acetabular fracture with plain radiographs and three-dimensional computerized tomographic scan", J Orthop Surg(Hong Kong), 8, pp.33~37 (2000)
- Moed BR, "Results of operative treatment of fractures of the posterior wall of the acetabulum", J Bone Joint Surg Am, 84(A), pp.752~758 (2002)