Главная Тезисы Повреждения и заболевания костей таза ANALYSIS OF THE RESULTS OF PATIENT TREATMENT WITH PELVIS FRACTURES

ANALYSIS OF THE RESULTS OF PATIENT TREATMENT WITH PELVIS FRACTURES

During the period from 1998 to 2005,56 patients with pelvis fractures and luxation fractures of the hip joint were treated. There were 29 men and 27 women. The age of patients was from 29 to 64. The lesion structure was estimated according to A. V. Kaplan classification. Fractures of the pelvic ring without lesions of its integrity were in 8 patients, fractures of femoral cavity in 30, fractures of femoral cavity and pelvic ring in 18 patients. The recent cases were in 13 patients, old ones in 35 cases.

The following types of operative interventions were used:

  • internal osteosynthesis of anterior, posterior columns (by plate with screws, screws);
  • internal osteosynthesis of anterior, posterior walls and roof of femoral cavity (by plate with screws, screws) with open reduction in the presence of luxation of the head of femoral bone;
  • total endoprothesis of the hip joint with bone autoplasty (from ablated head of the femoral bone) of posterior, anterior side and roof of the acetabular cavity;
  • internal osteosynthesis with bone alloplasty of posterior side and roof of the hip cavity.
The choice of the treatment method depended on the severity and long standing of trauma, general state of a patient, the aim of which was reliable fracture fixation and early limb function. The preference was given to osteosynthesis, and endoprotheses was made in old cases with the compromised head of femoral bone. Internal osteosynthesis with bone alloplasty of posterior side and roof of the hip cavity was performed in old cases if it was impossible to align fragments and with safe head of the femoral bone. Further it led to the rapid progress of deforming arthrosis, pronounced pain syndrome, the patients needed total endoprostheses of the hip joint. The analysis of results of those cases showed that with old dislocation fractures in the hip joint more effective is total replacement of the hip joint with bony autoplasty of defects.

In recent cases we consider osteosynthesis and open reduction of the head dislocation being more expedient In unstable fractures of the pelvic ring the use of internal osteosynthesis permitted to ensure the reliable fixation of the fracture site, perform the revision of the fracture site and in case of necessity to perform the primary bone plasty in old cases.

G. V. Gayko, L.P. Kukuruza, Y. V. Lymar
Clinic of Orthopedy and Traumatology of adults, Institute of Traumatology and Orthopedy AMN of Ukraine, Kiev

 

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