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S A Park 1 Article
Surgical treatment of Unstable Acetabular Fracture Clinical analysis of 28 cases with consideration of surgical problems and complications
I Kim, Y K Woo, Y S Kim, S W Song, S Y Kwon, S A Park
J Korean Soc Fract 1994;7(2):444-456.   Published online November 30, 1994
DOI: https://doi.org/10.12671/jksf.1994.7.2.444
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Authors reviewed total 28 cases of acetabular fracture with operative management followed up over 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications. The overall results were as follows: 1. According to the classification by Judet and Letoumel(1974), 20 cases were elementary fractures and 8 cases were associated fractures. The posterior wall fractures were most common in 9 case. 2. Kocher-Langenbeck approach in 18 cases, ilioinguinal in 4 cases, iliofemoral in 4 cases and triradiate transtrochanteric approach in 2 cases were used. 3. The devices for internal fixation were as follows screw only in 8 cases. plate and screw in 14 cases, plate and screw with circumferential wiring In 4 cases, wire and staple only in 1 each case. 4. The early and late complications occurred postoperatively as follows : incomplete sciatic nerve palsy 2 cases, wound infection 2 cases as early complications and posttraumatic arthritis 6 cases. avascular necrofis of femoral head 2 cases, heterotropic ossification 1 case as late complications. Two cases of sciatic nerve palsy were spontaneously recovered and 2 cases of wound infection were controlled by adequate drainage and antibiotic therapy. And then, the total hip arthroflasty were carried out for 2 cases of avascular necrosis of femoral head, and 6 cases of posttaumatic arthritis and 1 case of heterotopic ossification were under observation. 5. Postoperatively, the causes of inadequate reduction and insufficient fixation were radiographically analyzed with immediate]y and lastly checked plain films, of which causes in 9 cases were as follows : inappropriate approach for exposure in 4 cases, delayed operation due to major associated injury over 3 weeks in 3 cases and severe comminution in 2 cases. As a result, we reached to put an emphasis on an importatnce of preoperative planning, including the evaluation of individual fracture personality, the choice of surgical approach and the method of internal fixation.
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