genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2023-29-2-137-147BTLEPGgenort-2830Research ArticleОригинальные статьиOriginal articlesРезультаты хирургического лечения пациентов с переломами вертлужной впадины и квадрилатеральной поверхностиSurgical outcomes of patients with acetabular fractures and quadrilateral plate involvementhttps://orcid.org/0000-0003-3341-7446ДонченкоС. В.DonchenkoS. V.

Сергей Викторович Донченко – кандидат медицинских наук, заведующий травматологическим отделением

Москва

Sergey V. Donchenko – Candidate of Medical Sciences

Moscow

Don_03@mail.ruhttps://orcid.org/0000-0003-1435-8743КолесникА. И.KolesnikA. I.

Александр Иванович Колесник – доктор медицинских наук, профессор

Москва

Alexander I. Kolesnik – Doctor of Medical Sciences, Professor

Moscow

ko-lesnik@mail.ruhttps://orcid.org/0000-0003-3668-2376СуриковВ. В.SurikovV. V.

Владислав Владимирович Суриков – аспирант кафедры

Москва

Vladislav V. Surikov – M.D.

Moscow

Airbag366@yandex.ruhttps://orcid.org/0000-0002-5821-6774ИвановД. А.IvanovD. A.

Дмитрий Александрович Иванов – заведующий отделением

Московская область, Лыткарино

Dmitriy A. Ivanov

Moscow region

Ivanovda2001@mail.ruhttps://orcid.org/0000-0002-3960-0148ТарасовЕ. П.TarasovE. P.

Евгений Петрович Тарасов

Московская область, Одинцово

Evgeniy P. Tarasov 

Moscow region

t.john@mail.ruhttps://orcid.org/0000-0002-4580-5502ЯрмамедовД. М.YarmamedovD. M.

Дмитрий Муталифович Ярмамедов – ассистент кафедры

Курск

Dmitry M. Yarmamedov

Kursk 

D-yarmamedov@mail.ruhttps://orcid.org/0000-0001-8219-5582СолодиловИ. М.SolodilovI. M.

Иван Михайлович Cолодилов – кандидат медицинских наук, врач травматолог-ортопед

Курск

Ivan M. Solodilov – M.D.

Kursk 

Ivan_s_007@mail.ruГородская клиническая больница имени С.П. БоткинаРоссияCity clinical hospital named after S.P. BotkinRussian FederationЦИТОПРОЕКТРоссияCYTOPROJECT LLCRussian FederationГородская клиническая больница имени С.П. Боткина; Российская медицинская академия непрерывного профессионального образованияРоссияCity clinical hospital named after S.P. Botkin; Russian Medical Academy of Continuous Professional EducationRussian FederationЛыткаринская городская больницаРоссияLytkarino city hospitalRussian FederationОдинцовская областная больницаРоссияOdintsovo city hospitalRussian FederationКурский государственный медицинский университетРоссияKursk State Medical UniversityRussian FederationКурская городская клиническая больница № 4РоссияKursk city clinical hospital No. 4Russian Federation202328042023292137147Copyright © Донченко С.В., Колесник А.И., Суриков В.В., Иванов Д.А., Тарасов Е.П., Ярмамедов Д.М., Солодилов И.М., 20232023Донченко С.В., Колесник А.И., Суриков В.В., Иванов Д.А., Тарасов Е.П., Ярмамедов Д.М., Солодилов И.М.Donchenko S.V., Kolesnik A.I., Surikov V.V., Ivanov D.A., Tarasov E.P., Yarmamedov D.M., Solodilov I.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/2830Актуальность

Актуальность. Открытая репозиция и внутренняя фиксация (ORIF) остаются стандартным способом лечения переломов вертлужной впадины (ВВ). Многие авторы в случаях наличия переломов квадрилатеральной поверхности вертлужной впадины отмечают плохие результаты применения ORIF.

Цель

Цель. Оценить результаты оперативного лечения пациентов с переломами вертлужной впадины и квадрилатеральной поверхности (КЛП).

Материалы и методы

Материалы и методы. Проведен ретроспективный анализ хирургического лечения 55 пациентов с переломами вертлужной впадины и квадрилатеральной поверхности с 2009 по 2019 год. Ранние послеоперационные результаты прослежены у всех 55 пациентов. В контрольной группе оперировано 32 (58,2 %) пациента с переломами ВВ, в основной группе оперировано 23 пациента (41,8 %) с переломами ВВ в сочетании с переломами КЛП. Отдаленные результаты изучены у 45 пациентов в возрасте от 18 до 60 лет с переломами вертлужной впадины (контрольная группа, n = 24) и в сочетании с переломами квадрилатеральной поверхности (основная группа, n = 21).

Результаты

Результаты. Оперативные вмешательства выполнены одной бригадой в составе одних и тех же специалистов. Результаты хирургического лечения в обеих клинических группах оценивались по 11 критериям. Обсуждение. Результаты хирургического лечения переломов ВВ и квадрилатеральной поверхности связаны с негативным влиянием переломов КЛП на длительность и объем кровопотери, диагностированные интраоперационные и поздние осложнения, динамику развития посттравматического артроза ТБС. Полученные результаты сопоставимы с данными цитируемых источников.

Заключение

Заключение. Сравнительный анализ результатов доказал факт негативного влияния переломов КЛП на результаты хирургического лечения и подтверждает объективную необходимость отнесения переломов КЛП к факторам риска получения неблагоприятных исходов при выполнении ORIF.

Background Open reduction and internal fixation (ORIF) remain the standard method of treating acetabular fractures. Many authors report poor results in quadrilateral plate fractures of the acetabulum with the use of ORIF. The objective was to evaluate outcomes of quadrilateral plate fractures of the acetabulum.

Material and methods Surgical outcomes of 55 patients with quadrilateral plate fractures of the acetabulum were retrospectively reviewed between 2009 and 2019. Early postoperative results were followed up in 55 patients. Surgical treatment was provided for 32 (58.2 %) control patients with acetabular fractures and 23 patients (41.8 %) with quadrilateral plate fractures of the acetabulum in the main group. Long-term results were explored in 45 patients aged 18 to 60 years with acetabular fractures (control group, n = 24) and in combination with quadrilateral plate involvement (main group, n = 21).

Results Surgical interventions were performed by one team consisting of the same specialists. Surgical outcomes in oth clinical groups were evaluated according to 11 criteria.

Discussion The results of surgical treatment of acetabular fractures and quadrilateral plate involvement were associated with the negative impact of quadrilateral plate involvement on the duration and volume of blood loss, intraoperative and late complications and dynamics in the development of post-traumatic hip arthrosis. The results obtained were comparable with the data of the itation sources.

Conclusion A comparative analysis of the outcomes suggested a negative impact of quadrilateral plate involvement on the results of surgical treatment and an objective necessity to rank quadrilateral plate fractures of the acetabulum as a risk factor for adverse outcomes with ORIF.

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The authors declare that there are no conflicts of interest present.