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Fractures of the acetabulum - surgical treatment and complications

机译:髋臼骨折 - 手术治疗和并发症

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Acetabular fractures represent severe injuries that mostly occur in car accidents, or after falling from greater heights, most often in the working male population. Acetabular fractures are present in our clinical practice and require a good education and surgical training. Surgical experience is one of the prerequisites for achieving good treatment results, because these fractures are accompanied by numerous complications. In order to acquire knowledge and skills in this field of surgery, it is necessary to have a national center for education at one of the Medical Faculties in Serbia. All dislocated acetabular fractures (? 2mm), require early surgery, anatomical reduction and stable internal fixation of acetabular fracture. Acetabular fracture-dislocation requires urgent reduction of the dislocated femoral head. The anatomic reduction of the fracture is related to the time of definitive bone fixation of the fracture. After 14 days from the fracture, anatomic reduction is more difficult to achieve. In addition to these factors that positively affect the final results of treatment, there are negative factors as well, that result in poor outcomes. They are directly correlated to the initial trauma that occurs at the time of injury. Fracture comminution, large dislocation ( 20mm), injury of the femoral head, posterior dislocation of the hip, impaction, traumatic or iatrogenic sciatic nerve palsy, are factors that negatively affect the results and are responsible for complications, as opposed to positive factors.
机译:髋臼骨折代表严重伤害,大多数发生在汽车事故中,或者在从更高的高度下降后,最常见于工作男性人口。在我们的临床实践中存在髋臼骨折,需要良好的教育和外科培训。手术经验是实现良好治疗结果的先决条件之一,因为这些骨折伴有许多并发症。为了获得这一手术领域的知识和技能,有必要在塞尔维亚的一位医学院拥有国家教育中心。所有脱臼的髋臼骨折(β2mm)需要早期手术,解剖减少和稳定的髋臼骨折内固定。髋臼骨折脱位需要紧急减少脱位的股头。骨折的解剖学还原与骨折的最终骨固定的时间有关。从骨折起14天后,解剖减少更难以实现。除了积极影响治疗结果的因素外,还存在负面因素,导致结果不佳。它们与在受伤时发生的初始创伤直接相关。骨折粉碎,大脱位(> 20mm),股骨头损伤,髋关节,浸润,创伤或性能坐骨神经麻痹的后脱位,是对结果产生负面影响的因素,并对并发症负责,而不是积极因素。

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