Posterior Kalça Çıkığının Eşlik Ettiği Asetabulum Kırıklarında Klinik ve Radyolojik Sonuçlar

GİRİŞ ve AMAÇ: Çalışmamızda asetabulum kırıklarına eşlik eden posterior kalça çıkığının insidansı ve bunun asetabulum kırıkları cerrahi tedavisindeki etkileri değerlendirildi. YÖNTEM ve GEREÇLER: Cerrahi olarak tedavi edilen 172 asetabulum kırığı vakası retrospektif olarak değerlendirildi. Bunların 53'ünde posterior kalça çıkığı vardı. Takipleri yetersiz olan 15 hasta çalışma dışı bırakıldıktan sonra kalan 38 hasta son takip bulguları eşliğinde radyolojik ve klinik olarak değerlendirildi. Asetabular kırık tipine göre gruplanarak sonuçlar karşılaştırıldı. BULGULAR: 38 hastanın 19'unda (%50) basit tip 19'unda ise kompleks tip asetabulum kırığı mevcuttu. Postoperatif klinik ve radyolojik sonuçlar basit tip kırıklarda istatistiksel anlamlı olarak daha iyiydi. Dokuz hastada (%23.7) preoperatif siyatik sinir lezyonu vardı. Total kalça artroplastisi sekiz hasta için gerekli oldu, bunların üçü ilk yıl içinde avasküler nekroz kaynaklı yapıldı. TARTIŞMA ve SONUÇ: Çalışmamızda asetabulum kırıklarında posterior kalça çıkığı insidansı %30.8 olarak bulundu. Asetabulum kırıklarına posterior kalça çıkıklarının eşlik etmesi klinik ve radyolojik sonuçları kötü olarak etkileyebilmektedir.

Clinical and Radiological Outcomes of Posterior Hip Dislocation with Acetabular Fractures

INTRODUCTION: Our study analyzes the incidence of posterior hip dislocation in the acetabular fractures. The effect of hip dislocation on the surgical treatment of acetabular fracture was also evaluated. METHODS: 172 surgically treated acetabular fracture cases were evaluated retrospectively. Of these, 53 patients had posterior hip dislocation with acetabular fractures. Fifteen patients were excluded from the study due to loss of follow-up. Clinical and radiological grading of remaining 38 patients were assessed at the final follow-up. Comparative studies were performed between groups, which were done according to acetabular fracture type, clinical and radiological results. RESULTS: 19 (50%) out of 38 acetabular fracture dislocations were simple and 19 (50%) were complex type acetabular fracture. The postoperative clinical and radiological results have been significantly better in simple type fracture group, than the complex acetabular fracture group. Nine patient (23.7%) had preoperative sciatic nerve palsy. Total hip arthroplasty were required in eight patients, three of them had avascular necrosis of femoral head and operated within first year. DISCUSSION AND CONCLUSION: In our study posterior dislocations were seen in 30.8% of acetabular fractures. Posterior hip dislocation accompanies in one third of the acetabular fractures and this may influence the clinical and radiological outcome.

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