COMPARATIVE CHARACTERISTICS OF TREATMENT METHODS FOR FLOATING HIP FRACTURES IN PATIENTS WITH POLYTRAUMA
DOI:
https://doi.org/10.32689/2663-0672-2024-2-7Keywords:
floating hip, victim, polytrauma, treatment, resultsAbstract
Hip and pelvic injuries are among the main causes of mortality among patients with musculoskeletal injuries. The variety of pelvic and hip injuries is not only an urgent and complex problem of modern traumatology, but also a serious medical and social problem. Purpose: To compare the results of different methods of surgical treatment of victims with ipsilateral hip fractures as a result of polytrauma. Materials and methods: The work analyzed the treatment of 77 cases of ipsilateral hip fractures as a result of polytrauma. The patients were treated in the polytrauma department of the Kyiv City Clinical Emergency Hospital in the period 2014-2023 and met the selection criteria for our study. Results: Among patients with MOS plates, an excellent result was found twice as often as among patients after total arthroplasty. A similar pattern was found among patients with a good result, when this result was found twice as often among patients after hip arthroplasty. The difference was even greater among patients with an unsatisfactory result. Among patients with MOS plate, a significant preponderance of cases of unsatisfactory results was found. If in the first group the number of unsatisfactory results was 18.6%, then in the second group only 2.9% of cases. Conclusions: Despite the existing strategy for the treatment of floating hip, which prioritizes open reduction and MOS plates, in our study in victims with floating hip as a result of polytrauma, we obtained significantly better treatment results when using total hip arthroplasty in this category of patients.
References
Анкін М. Л., Анкін Л. М., Бурлука В.В., Ткаченко А. Є., Саламащак В. В. Характер і структура ушкоджень тазової ділянки в постраждалих із політравмою і нестабільним тазовим кільцем. Ортопедия, травматология и протезирование. 2016. №1. с.5–9.
Верескун Р. В., Петросянц С. В. Шалимов С. А. , Прихода Д. В., Иванов А.С. Тактика лечения пациентов из сочетанными переломами таза и бедра. Проблеми травматології та остеосинтезу. 2018. №1-2 (11-12) С. 20–25
Копитчак І. Р. Лікування скелетних пошкоджень у пацієнтів з політравмою. Травма. 2014. (Т15). №2. С.108–110
Borg T, Hernefalk B, Hailer NP. Acute total hip arthroplasty combined with internal fixation for displaced acetabular fractures in the elderly: a short-term comparison with internal fixation alone after a minimum of two years. Bone Joint J. 2019 Apr;101-B(4):478-483. doi: 10.1302/0301-620X.101B4.BJJ-2018-1027.R2. PMID: 30929478.
Boudissa M, Francony F, Drevet S, Kerschbaumer G, Ruatti S, Milaire M, Merloz P, Tonetti J. Operative versus nonoperative treatment of displaced acetabular fractures in elderly patients. Aging Clin Exp Res. 2020 Apr;32(4):571–577. doi: 10.1007/s40520-019-01231-5. Epub 2019 Jun 10. PMID: 31183749.
Cohen DA, Montgomery SJ, Stavrakis A, Mears SC, Atrey A, Khoshbin A. Treatment of Geriatric Acetabular Fractures-A Concise Review of the Literature. Orthop Clin North Am. 2021 Oct;52(4):323–333. doi: 10.1016/j.ocl.2021.05.007. Epub 2021 Jul 29. PMID: 34538345.
Gänsslen A, Müller M, Nerlich M, et al. Acetabular Fractures. Diagnosis, Indications, Treatment Strategies. Thieme.2017. 339 P.
Giustra F, Cacciola G, Pirato F, Bosco F, De Martino I, Sabatini L, Rovere G, Camarda L, Massè A. Indications, complications, and clinical outcomes of fixation and acute total hip arthroplasty for the treatment of acetabular fractures: A systematic review. Eur J Orthop Surg Traumatol. 2023 Aug 28. doi: 10.1007/s00590-023-03701-z. Epub ahead of print. PMID: 37640795.
Harrison A, Ordas-Bayon A, Chimutengwende-Gordon M, Fortune M, Chou D, Hull P, Carrothers A, Rawal J. Factors associated with mortality in older patients sustaining pelvic or acetabular fractures. Arch Orthop Trauma Surg. 2022 Jul;142(7):1547–1556. doi: 10.1007/s00402-021-03873-5. Epub 2021 Apr 3. PMID: 33813616; PMCID: PMC9217874.
He W, Fu X, Chen S. Advancing polytrauma care: developing and validating machine learning models for early mortality prediction. J Transl Med. 2023 Sep 25;21(1):664. doi: 10.1186/s12967-023-04487-8. PMID: 37743498; PMCID: PMC10518974.
Kelly J, Ladurner A, Rickman M. Surgical management of acetabular fractures – A contemporary literature review. Injury. 2020 Oct;51(10):2267-2277. doi: 10.1016/j.injury.2020.06.016. Epub 2020 Jun 24. PMID: 32646650;
Leone E, Garipoli A, Ripani U, Lanzetti RM, Spoliti M, Creta D, Giannace C, Galluzzo A, Trinci M, Galluzzo M. Imaging Review of Pelvic Ring Fractures and Its Complications in High-Energy Trauma. Diagnostics (Basel). 2022 Feb 2;12(2):384. doi: 10.3390/diagnostics12020384. PMID: 35204475; PMCID: PMC8870907.
Walley K.C., Appleton P.T., Rodriguez E.K. Comparison of outcomes of operative versus non-operative treatment of acetabular fractures in the elderly and severely comorbid patient // Eur. J. Orthop. Surg. Traumatol. 2017. Vol. 27, No 5. P. 689–694. DOI: 10.1007/s00590-017-1949-1.
