Incidence of the Acetabuar Fracture In AL-Thawra Modern general hospital During 2009 –...
45
Incidence of the Acetabuar Fracture In AL-Thawra Modern general hospital During 2009 –Sana'a-Yemen
-
Upload
polly-patterson -
Category
Documents
-
view
217 -
download
3
Transcript of Incidence of the Acetabuar Fracture In AL-Thawra Modern general hospital During 2009 –...
Incidence of the Acetabuar Fracture
In AL-Thawra Modern general hospital
During 2009 –Sana'a-Yemen
الله. عبد سعيد دبامشموس
مقبل. صالح دالفيصلي
Ant. View of ACETABULAM
Post. View of ACETABULAM
.Callisen in 1788 start to said and to have reported the case of an acetabular fracture
During 2009
7070 patientspatients withwith
acetabular acetabular fracturesfractures
Gender Gender distribution of 70 distribution of 70 patients with acetabular patients with acetabular
fracturesfractures
14(20%)
56 cases(80%)
The main cause of fracture is DISLUCATION OF THE HIP
● this injury is due to massive force transmitted along the femoral shaft, e.g. road traffic accidents or a back injury in someone kneeling.
distribution of 70 patients with distribution of 70 patients with acetabular fracture according acetabular fracture according
to to mechanismmechanism of injury of injury
MECHANISM OF TRAUMA
GENDER FEMALE
T%
RTA4057%GUN SHOT57%
FALLING2130%OTHER46%
TOTAL70100.00%
Type of Dislocation depends Type of Dislocation depends on on positionposition ::
I. Anterior dislocation of hipI. Anterior dislocation of hip
NON FRACTURE OF ACETABULAM
7-10%7-10% OF DISOF DIS
II. Posterior dislocationII. Posterior dislocation
Most common type of dislocationMost common type of dislocation..
Posterior rim is usually Posterior rim is usually fracturedfractured
Associated Associated sciatic nervesciatic nerve injury injury in 10%in 10%
flexed ,shortened ,adducted and internally rotated
III. CENTRAL dislocationIII. CENTRAL dislocation
Direct impact to the aspect of the hip through the acetabulum.
This is a fracture -dislocation.
Distribution of the acetabualr Distribution of the acetabualr fracture by fracture by age groupage group and and
gendergenderAGE
GROUPS
GENDERTOTAL
MFN%
19-2073107%
21-303674330.1%
31-40111128.4%
41-504132.1%
51-609296.3%
TOTAL561470100.00%
I. AP I. AP View View pelvispelvis
ACETABLUMFEMORAL HEAD
GREATERTROCHANTER
LESSER TROCHANTER
FEMORAL NECK
CORTICAL BONE
MEDULLARY BONE
FOVEA CAPITIS
II. JUDET viewOBTURATOR
(Internal oblique view)
III . JUDET viewIliac (exteternal oblique view)
WE CAN DIAGNOSEDTHE FRACTUREIN ONE OF 3 VIEW
CT is a very useful to CT is a very useful to assessment and planning of assessment and planning of surgerysurgery..
7070 patients with acetabular fracture patients with acetabular fracture accoding to accoding to associated injuresassociated injures
ASSOCIATED TRAUMATOTAL
N%
MULTIBLE TRAUMA2738%
ISOLATED ACETABULAR FRACTURE
4362%
TOTAL70100%
Distrubiton of acetabular fracture Distrubiton of acetabular fracture according to according to departementdepartement of intial of intial admissionadmission
DEPARTMENTGENDERTOTAL
MFT%
INTENSIVE CARE UNIT52710%
SURGICAL DEP.72912.8%
ORTHOPEDIC DEP.3584361.4
%NEUROSURGICAL DEP.4157%
UROLOGY DEP.5168.5%
TOTAL561470100%
associated injuryassociated injury
distribution of complication releated to distribution of complication releated to the associated injury in 27 patientsthe associated injury in 27 patients::
ASSOCIATED INJURIEN%
LIMBS622.2
VASCULAR316.2
NEUROLOGY211.6
UROLOGY933.3
ABOMINAL34.6
THORACIC42.3
TOTAL2738%
We used Letournel We used Letournel ANATOMICAL ANATOMICAL
system system classificationclassification
TYPE OF CLASSIFICATION
NO%
SIMPLE FRACTURE TYPE
posterior wall 2028%
posterior column34.2%
anterior wall11.4%
anterior column22.8%
transverse 710%
ASSOCIATED FRACTURE TYPE
posterior column +posterior wall11.4%
transverse +posterior wall1115.7%
T- shape57%
anterior column or wall + posteriorhemitransverase
811.4%
both column1217%
TreatmentTreatment
I. Closed reductionI. Closed reduction ( ( to reduce painto reduce pain) )
II. SURGICALII. SURGICAL
Closed reductionClosed reduction
Four Four methods of methods of closed reductionclosed reduction: :
1.
22 . .Allis Allis tractiontraction
3.
44. . ClassicalClassical
watson`s– jones methodwatson`s– jones method: :
Skin TractionSkin Traction
Skeletal tractionSkeletal traction
II. SURGICAL II. SURGICAL treatmenttreatment
should be considered forshould be considered for:: . .all displaced fractures of all displaced fractures of
the acetabulumthe acetabulum..
. .that do not meet the criteria that do not meet the criteria for nonoperative therapyfor nonoperative therapy..
Orthopaedic Orthopaedic Surgeon CanSurgeon CanGet You Back Get You Back
Into The GameInto The Game
