Journal of orthopaedic trauma
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To describe the clinical characteristics of combined injuries of the pelvis and acetabulum, which have not been previously described. We hypothesize that this combination of injuries affects not only the postinjury hemodynamics of the patient, but the outcome of subsequent acetabular fracture treatment. ⋯ Patients with combined pelvic and acetabular fractures represent a serious injury that includes the resuscitative challenges of pelvic injuries coupled with the difficulties of precise reduction of acetabular fractures. To obtain optimal reduction of the acetabulum, initial accurate reduction of the posterior pelvic lesion appears to be necessary.
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The purposes of this study were to evaluate the relationship between body mass index (BMI) and postoperative complications and to determine the incidence of reoperation after surgical treatment of pelvic ring injuries. ⋯ Body mass index correlates with an increased rate of complications and reoperation after operative treatment of pelvic ring injuries.
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Intra-articular screw placement during acetabular surgery must be avoided. To date, no anatomic guidelines exist to prevent intra-articular screw placement in the treatment of complex acetabular fractures by the ilioinguinal or Stoppa approach. ⋯ This study identifies a safe zone for screw placement in the treatment of acetabular fractures when operated by an anterior approach. These findings have the potential to prevent further injury to the acetabular and femoral cartilage as a result of the surgical trauma and minimize intraoperative irradiation time.
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We assessed whether, in contrast to reports in the literature, computed tomographic (CT) scans improve the ability to classify acetabular fractures in comparison with plain radiographs. ⋯ In contrast to previous reports in the literature, the accuracy of plain radiographs alone was less than the accuracy of CT scans in terms of diagnosis. The interobserver reliability was also worse for plain radiographs alone.
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The objective of this study was to evaluate acetabular fractures in elderly patients treated with open reduction internal fixation combined with acute total hip arthroplasty during the same anesthetic. ⋯ The combined hip procedure is an option for acetabular fractures in elderly patients. Complications, surgical times, and hospitalizations are consistent with open reductions or belated total hip arthroplasties. Aggressive medical workups may be needed, but a single posterior surgical procedure will avoid the "wait-and-see" approach often used for these patients.