One-stage total hip arthroplasty for the treatment of special acetabular fracture

doi:10.3969/j.issn.2095-4344.2013.43.003

Abstract

Abstract:

BACKGROUND: The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head.
OBJECTIVE: To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture.
METHODS: Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of falling injury. The type of bone fracture: two cases of posterior wall fracture, two cases of posterior column and posterior wall fracture, one case of T shaped fracture, five cases of transverse and posterior wall fracture, and two cases of acetabular roof sexual fracture. Complications: one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. All the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were followed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery.
RESULTS AND CONCLUSION: No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were followed-up for a longtime; the follow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final follow-up according to the Harris score: excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functionally.

Key words: acetabulum, fractures, internal fixators, arthroplasty, replacement, follow-up studies

CLC Number:

R318

Guan Qun, Feng Shi-long, Tang Jin, Liao Yi-ming, Yang Tao, Cheng Jun. One-stage total hip arthroplasty for the treatment of special acetabular fracture[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.43.003.

Figures/Tables 2

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