Araştırma Makalesi
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Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures

Yıl 2022, Cilt: 24 Sayı: 1, 34 - 38, 30.04.2022
https://doi.org/10.18678/dtfd.1033059

Öz

Aim: Acetabular fractures were evaluated by Judet and Letournel in two main groups as elementary and associated fractures. There are publications in the literature that the results are worse as the complexity of the fracture increases. The aim of this study was to evaluate whether clinical outcomes are worse in associated fractured patients.
Material and Methods: The study included 48 acetabular fractures admitted to the emergency room and treated surgically between December 2011 and October 2020. Patient’s trauma, additional injuries, surgical method, early or late complications, and range of motion at the last follow-up were documented. Clinical and radiological results of the patients were evaluated by modified Merle d'Aubigné, functional capacities by Harris hip scoring systems.
Results: There were 25 elementary fractures and 23 associated fractures in patients. When the complication rates were examined, the rate of those without complications was 52.0% (n=13) among elementary fractures, while the rate was 34.8% (n=8) in associated fractures. When the fracture types were evaluated according to the Harris hip score, elementary fractures have better score than associated fractures, but no statistically significant difference was observed between them (p=0.056). When evaluated according to Merle d'Aubigne score, it was observed that elementary fractures had significantly better scores (p=0.004).
Conclusion: As the complexity of the fracture increases, it can be predicted that the clinical outcomes of the patient will be worse. It is also concluded that the elementary fracture type had better clinical outcomes than the associated fracture type in our own surgically treated acetabular fractures.

Kaynakça

  • Kelly J, Ladurner A, Rickman M. Surgical management of acetabular fractures – A contemporary literature review. Injury. 2020;51(10):2267-77.
  • Lundin N, Huttunen TT, Berg HE, Marcano A, Felländer-Tsai L, Enocson A. Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden. Injury. 2021;52(6):1410-7.
  • Meena UK, Tripathy SK, Sen RK, Aggarwal S, Behera P. Predictors of postoperative outcome for acetabular fractures. Orthop Traumatol Surg Res. 2013;99(8):929-35.
  • Giannoudis PV, Bircher M, Pohlemann T. Advances in pelvic and acetabular surgery. Injury. 2007;38(4):395-6.
  • Judet R, Judet J, Letournel E. Fractures of the acetabulum: Classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-46.
  • Briffa N, Pearce R, Hill Am, Bircher M. Outcomes of acetabular fracture fixation with ten years’ follow-up. J Bone Joint Surg Br. 2011;93(2):229-36.
  • Boyd HB, Griffin LL. Classification and treatment of trochanteric fractures. Arch Surg. 1949;58(6):853-66.
  • Mears DC, Velyvis JH, Chang CP. Displaced acetabular fractures managed operatively: indicators of outcome. Clin Orthop Relat Res. 2003;407:173-86.
  • Bilekdemir U, Civan O, Cavit A, Özdemir H. Acetabular fractures treated surgically: Which of the parameters affect prognosis. Ulus Travma Acil Cerrahi Derg. 2020;26(2):265-73.
  • Nayak T, Mittal S, Trikha V, Farooque K, Gamanagatti S, Sharma V. Short-term results of surgical treatment of acetabular fractures using the modified Stoppa approach. J Clin Orthop Trauma. 2020;11(6):1121-7.
  • Jain M, Kumar P, Tripathy SK, Behera S 2nd, Rana R, Das S. Clinico-radiological outcomes of using modified stoppa approach for treating acetabular fractures: An institutional review. Cureus. 202024;12(4):e7821.
  • Trikha V, Das S, Aruljothi V, Chowdhury B. Prospective evaluation of outcome of acetabular fractures managed by anterior intrapelvic approach. Indian J Orthop. 2020;54(Suppl 2):228-38.
  • Bueno TSP, Godoy GP, Furukava RB, Gaggioli NT, Tamaoki MJS, Matsunaga FT, et al. Heterotopic ossification in acetabular fractures: Systematic review and meta-analysis of prophylaxis. Acta Ortop Bras. 2021;29(6):331-40.
  • Guyton JL, Perez EA. Fractures of acetabulum and pelvis. In: Canale ST, Beaty JH, Campbell WC, editors. Campbell’s operative orthopaedics. 12th ed. St. Louis, Mo. : Elsevier/Mosby; 2012. p.2777-814.
  • Madhu R, Kotnis R, Al-Mousawi A, Barlow N, Deo S, Worlock P, et al. Outcome of surgery for reconstruction of fractures of the acetabulum. The time dependent effect of delay. J Bone Joint Surg Br. 2006;88(9):1197-203.
  • Johnson EE, Matta JM, Mast JW, Letournel E. Delayed reconstruction of acetabular fractures 21-120 days following injury. Clin Orthop Relat Res. 1994;305:20-30.
  • Elmali N, Ertem K, Inan M, Ayan I, Denizhan Y. [Clinical and radiologic results of surgically-treated acetabular fractures]. Acta Orthop Traumatol Turc. 2003;37(2):97-101. Turkish.
  • Değirmenci E, Orhan Z, Arıcan M, Karaduman Z, Turhan Y, Turhal O. Surgically treated posterior acetabular fractures via iselin’s modified approach with a short-term follow-up. Middle Black Sea Journal of Health Science. 2019;5(2):93-9.
  • 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. 1996;78(11):1632-45.

Cerrahi Olarak Tedavi Edilen Asetabulum Kırıklarının Klinik ve Radyolojik Değerlendirmesi

Yıl 2022, Cilt: 24 Sayı: 1, 34 - 38, 30.04.2022
https://doi.org/10.18678/dtfd.1033059

Öz

Amaç: Asetabulum kırıkları Judet ve Letournel tarafından elementer ve kompleks kırıklar olmak üzere iki ana grupta değerlendirilmiştir. Literatürde kırığın kompleksitesi arttıkça sonuçların daha da kötüleştiğine dair yayınlar bulunmaktadır. Bu çalışmanın amacı, kompleks kırıklı hastalarda klinik sonuçların daha kötü olup olmadığını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya, Aralık 2011 ve Ekim 2020 tarihleri arasında acil servise başvuran ve cerrahi olarak tedavi edilen kırk sekiz asetabulum kırığı dahil edildi. Hastaların travmaları, ek yaralanmalar, cerrahi yöntem, erken ve geç komplikasyonları ve son takipteki hareket açıklıkları kaydedildi. Hastaların klinik ve radyolojik durumları modifiye Merle d'Aubigné skoru ile ve fonksiyonel kapasiteleri ise Harris kalça skoru ile değerlendirildi.
Bulgular: Yirmi beş hastada elementer kırık ve 23 hastada kompleks kırık mevcuttu. Komplikasyon oranları incelendiğinde elementer kırıklar içerisinde komplikasyon olmayanların oranı %52,0 (n=13) iken, kompleks kırıklarda oran %34,8 (n=8) idi. Kırık tipleri Harris kalça skoruna göre değerlendirildiğinde, elementer kırıklar kompleks kırıklardan daha iyi skora sahip olmakla birlikte aralarında istatistiksel olarak anlamlı bir farklılık gözlenmemiştir (p=0,056). Merle d'Aubigné, skoruna göre değerlendirildiğinde elementer kırıkların anlamlı derecede daha iyi skorlara sahip olduğu görüldü (p=0,004).
Sonuç: Kırığın kompleksitesi arttıkça hastanın klinik sonuçlarının daha kötü olacağı tahmin edilebilir. Cerrahi olarak tedavi edilmiş asetabulum kırıklı kendi olgularımızda da, elementer kırık tipinin kompleks kırık tipine göre daha iyi klinik sonuçlara sahip olduğu sonucuna ulaşıldı.

Kaynakça

  • Kelly J, Ladurner A, Rickman M. Surgical management of acetabular fractures – A contemporary literature review. Injury. 2020;51(10):2267-77.
  • Lundin N, Huttunen TT, Berg HE, Marcano A, Felländer-Tsai L, Enocson A. Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden. Injury. 2021;52(6):1410-7.
  • Meena UK, Tripathy SK, Sen RK, Aggarwal S, Behera P. Predictors of postoperative outcome for acetabular fractures. Orthop Traumatol Surg Res. 2013;99(8):929-35.
  • Giannoudis PV, Bircher M, Pohlemann T. Advances in pelvic and acetabular surgery. Injury. 2007;38(4):395-6.
  • Judet R, Judet J, Letournel E. Fractures of the acetabulum: Classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-46.
  • Briffa N, Pearce R, Hill Am, Bircher M. Outcomes of acetabular fracture fixation with ten years’ follow-up. J Bone Joint Surg Br. 2011;93(2):229-36.
  • Boyd HB, Griffin LL. Classification and treatment of trochanteric fractures. Arch Surg. 1949;58(6):853-66.
  • Mears DC, Velyvis JH, Chang CP. Displaced acetabular fractures managed operatively: indicators of outcome. Clin Orthop Relat Res. 2003;407:173-86.
  • Bilekdemir U, Civan O, Cavit A, Özdemir H. Acetabular fractures treated surgically: Which of the parameters affect prognosis. Ulus Travma Acil Cerrahi Derg. 2020;26(2):265-73.
  • Nayak T, Mittal S, Trikha V, Farooque K, Gamanagatti S, Sharma V. Short-term results of surgical treatment of acetabular fractures using the modified Stoppa approach. J Clin Orthop Trauma. 2020;11(6):1121-7.
  • Jain M, Kumar P, Tripathy SK, Behera S 2nd, Rana R, Das S. Clinico-radiological outcomes of using modified stoppa approach for treating acetabular fractures: An institutional review. Cureus. 202024;12(4):e7821.
  • Trikha V, Das S, Aruljothi V, Chowdhury B. Prospective evaluation of outcome of acetabular fractures managed by anterior intrapelvic approach. Indian J Orthop. 2020;54(Suppl 2):228-38.
  • Bueno TSP, Godoy GP, Furukava RB, Gaggioli NT, Tamaoki MJS, Matsunaga FT, et al. Heterotopic ossification in acetabular fractures: Systematic review and meta-analysis of prophylaxis. Acta Ortop Bras. 2021;29(6):331-40.
  • Guyton JL, Perez EA. Fractures of acetabulum and pelvis. In: Canale ST, Beaty JH, Campbell WC, editors. Campbell’s operative orthopaedics. 12th ed. St. Louis, Mo. : Elsevier/Mosby; 2012. p.2777-814.
  • Madhu R, Kotnis R, Al-Mousawi A, Barlow N, Deo S, Worlock P, et al. Outcome of surgery for reconstruction of fractures of the acetabulum. The time dependent effect of delay. J Bone Joint Surg Br. 2006;88(9):1197-203.
  • Johnson EE, Matta JM, Mast JW, Letournel E. Delayed reconstruction of acetabular fractures 21-120 days following injury. Clin Orthop Relat Res. 1994;305:20-30.
  • Elmali N, Ertem K, Inan M, Ayan I, Denizhan Y. [Clinical and radiologic results of surgically-treated acetabular fractures]. Acta Orthop Traumatol Turc. 2003;37(2):97-101. Turkish.
  • Değirmenci E, Orhan Z, Arıcan M, Karaduman Z, Turhan Y, Turhal O. Surgically treated posterior acetabular fractures via iselin’s modified approach with a short-term follow-up. Middle Black Sea Journal of Health Science. 2019;5(2):93-9.
  • 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. 1996;78(11):1632-45.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Osman Görkem Muratoğlu 0000-0003-0049-7937

Murat Yilmaz Bu kişi benim 0000-0001-6468-7647

Doğan Atlihan Bu kişi benim 0000-0002-8562-0668

Cem Yildirim Bu kişi benim 0000-0003-4540-1927

Duran Can Muslu Bu kişi benim 0000-0002-5066-6666

Mahmud Aydın 0000-0002-2235-1480

Yayımlanma Tarihi 30 Nisan 2022
Gönderilme Tarihi 6 Aralık 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 24 Sayı: 1

Kaynak Göster

APA Muratoğlu, O. G., Yilmaz, M., Atlihan, D., Yildirim, C., vd. (2022). Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures. Duzce Medical Journal, 24(1), 34-38. https://doi.org/10.18678/dtfd.1033059
AMA Muratoğlu OG, Yilmaz M, Atlihan D, Yildirim C, Muslu DC, Aydın M. Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures. Duzce Med J. Nisan 2022;24(1):34-38. doi:10.18678/dtfd.1033059
Chicago Muratoğlu, Osman Görkem, Murat Yilmaz, Doğan Atlihan, Cem Yildirim, Duran Can Muslu, ve Mahmud Aydın. “Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures”. Duzce Medical Journal 24, sy. 1 (Nisan 2022): 34-38. https://doi.org/10.18678/dtfd.1033059.
EndNote Muratoğlu OG, Yilmaz M, Atlihan D, Yildirim C, Muslu DC, Aydın M (01 Nisan 2022) Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures. Duzce Medical Journal 24 1 34–38.
IEEE O. G. Muratoğlu, M. Yilmaz, D. Atlihan, C. Yildirim, D. C. Muslu, ve M. Aydın, “Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures”, Duzce Med J, c. 24, sy. 1, ss. 34–38, 2022, doi: 10.18678/dtfd.1033059.
ISNAD Muratoğlu, Osman Görkem vd. “Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures”. Duzce Medical Journal 24/1 (Nisan 2022), 34-38. https://doi.org/10.18678/dtfd.1033059.
JAMA Muratoğlu OG, Yilmaz M, Atlihan D, Yildirim C, Muslu DC, Aydın M. Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures. Duzce Med J. 2022;24:34–38.
MLA Muratoğlu, Osman Görkem vd. “Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures”. Duzce Medical Journal, c. 24, sy. 1, 2022, ss. 34-38, doi:10.18678/dtfd.1033059.
Vancouver Muratoğlu OG, Yilmaz M, Atlihan D, Yildirim C, Muslu DC, Aydın M. Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures. Duzce Med J. 2022;24(1):34-8.
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