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Z Orthop Unfall 2025; 163(01): 63-70
DOI: 10.1055/a-2265-0446
Original Article

Dislocation Does Not Seem To Be an Absolute Factor Effecting the Short- to Medium-Term Poor Prognosis of Patients with Acetabular Posterior Wall Fracture

Luxation scheint kein absoluter Faktor zu sein, der die kurz- bis mittelfristig schlechte Prognose von Patienten mit Azetabulumfrakturen der Hinterwand beeinflusst
Yunfeng Yao 
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Houlong Ye
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Wang Fang
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Ru Feng
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Chun Zhang
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Liujie Zheng
3   Department of Orthopaedic Surgery, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
,
Hao Lv
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Jun Li
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
,
Juehua Jing
1   Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2   Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
› Author AffiliationsSupported by: the Key Research and Development Project of Anhui Province 201904b11020032
Supported by: The Scientific Research Fund Project of Anhui Medical University 2021xkj041,2022xkj034
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Abstract

Background

Dislocation is a complication of acetabular fractures involving the posterior wall, but whether dislocation is an absolute factor impacting the short- to medium-term prognosis of the hip joint remains controversial. This study aimed to compare the short- to medium-term clinical and radiological results among patients diagnosed with an acetabular fracture involving the posterior wall, with or without dislocation.

Methods

Seventy-nine patients diagnosed with an acetabular fracture involving the posterior wall were retrospectively divided into posterior dislocation and non-dislocation groups. All fractures were open reduction + internal fixation with a plate screw combination through the single Kocher-Langenbeck approach. The short- to medium-term radiographic outcomes of follow-up were evaluated using the Matta radiologic grading system, while the clinical outcomes were evaluated using the modified Merle d’Aubigné-Postel evaluation system.

Results

The mean follow-up duration for all patients was 43.90 (range 24–75) months. Both groups achieved similar short- to medium-term clinical and radiographic results. There seems to be no significant differences between the two groups regarding the short- to medium-term assessment of clinical and radiographic results and the occurrence of postoperative complications (p > 0.05).

Conclusion

In patients with acetabular fractures involving the posterior wall, hip dislocation is probably not an absolute determinant of a poor outcome. Even with early reduction, the short- to medium-term prognosis results appear similar to those of patients without dislocation.

Zusammenfassung

Hintergrund

Eine Luxation ist eine Komplikation bei Azetabulumfrakturen der Hinterwand. Es besteht jedoch keine Einigkeit darüber, ob die Luxation ein absoluter Faktor ist, der die kurz- bis mittelfristige Prognose des Hüftgelenks beeinflusst. Ziel dieser Studie war es, die kurz- bis mittelfristigen klinischen und radiologischen Ergebnisse bei Patienten zu vergleichen, bei denen eine Azetabulumfraktur mit Beteiligung der hinteren Wand mit oder ohne Luxation diagnostiziert wurde.

Methode

79 Patienten, bei denen eine Azetabulumfraktur der hinteren Wand diagnostiziert wurde, wurden retrospektiv in 2 Gruppen unterteilt: die Gruppe mit hinterer Dislokation und die Gruppe ohne Dislokation. Alle Frakturen wurden sowohl offen reponiert als auch intern mit einer Platten-Schrauben-Kombination mit dem einfachen Kocher-Langenbeck-Zugang fixiert. Die kurz- bis mittelfristigen radiologischen Ergebnisse der Nachuntersuchung wurden anhand des radiologischen Klassifizierungssystems von Matta bewertet. Die klinischen Ergebnisse wurden anhand des modifizierten Merle d’Aubigné-Postel-Bewertungssystems beurteilt.

Ergebnisse

Die durchschnittliche Nachbeobachtungszeit für alle Patienten betrug 43,90 (Minimum 24 bis Maximum 75) Monate. Beide Gruppen erzielten kurz- bis mittelfristig vergleichbare klinische und radiologische Ergebnisse. Hinsichtlich der kurz- bis mittelfristigen Bewertung der klinischen und röntgenologischen Ergebnisse sowie des Auftretens von postoperativen Komplikationen scheinen keine signifikanten Unterschiede zwischen den beiden Gruppen zu bestehen (p > 0,05).

Schlussfolgerung

Bei Patienten mit Azetabulumfrakturen mit Beteiligung der Hinterwand ist die Hüftluxation wahrscheinlich kein absoluter Bestimmungsfaktor für ein schlechtes Ergebnis. Selbst bei frühzeitiger Reposition scheinen die kurz- bis mittelfristigen Prognoseergebnisse von Patienten mit Hüftluxation ähnlich zu sein wie die von Patienten ohne Luxation.

Keywords

acetabular fracture - posterior wall fracture - dislocation - non-dislocation

Schlüsselwörter

Azetabulumfraktur - Fraktur der hinteren Wand - Luxation - Nicht-Luxation


Publication History

Received: 06 March 2023

Accepted after revision: 08 February 2024

Article published online:
29 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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