Complicaciones de las fracturas de acetábulo

Introducción

El propósito de este trabajo es aportar nuestra experiencia mediante un estudio retrospectivo de las complicaciones de 110 fracturas del acetábulo tratadas entre 1997 y 2004. Las fracturas del acetábulo constituyen una patología de incidencia creciente, acompañando frecuentemente a politraumatismos. A diferencia de las fracturas del anillo pélvico, puede ser más frecuente la lesión aislada. La existencia de graves lesiones asociadas y complicaciones, locales o generales, hacen que su asistencia y toma de decisiones deba ser multidisciplinaria. La dificultad del tratamiento quirúrgico de las fracturas complejas y la baja prevalencia entre los distintos centros hospitalarios, que conlleva una corta experiencia individual, las ha convertido en un tema de interés para nuestra especialidad.

Material y método

El promedio de edad de los pacientes estudiados fue de 34 años y los mecanismos de producción mayoritariamente de moderada y alta energía, predominando los accidentes de tráfico y las precipitaciones. Cincuenta y nueve pacientes (53,6%) fueron tratados quirúrgicamente y el resto de forma ortopédica.

Resultados

Hubo un 35% de complicaciones.

Conclusiones

Nuestra serie pone de manifiesto que en estas fracturas pueden aparecer gran número de complicaciones y que este hecho exige aglutinar series y estudios multicéntricos para aumentar la experiencia, tanto en su manejo quirúrgico como evolutivo.

Introduction

With the aim of making a contribution to the treatment of acetabular fractures, in this paper we present a retrospective study of 110 fractures of the acetabulum treated between 1997 and 2004. Acetabular fractures are a pathology of growing incidence that is often accompanied by multiple trauma. Unlike pelvic ring fractures, acetabular injuries can often occur in isolation. Given the high incidence of serious injuries related to these fractures and of both localized and generalized complications the approach to this pathology as well as the decision-making process involved tend to be multi-disciplinary. There are two reasons why these fractures have become one of the most interesting topics in our field. The first of these is that these complex fractures tend to be very difficult to treat. The second, that their prevalence in the hospitals in our environment is very low, which acts as a limiting factor to the amount of experience of our physicians.

Material and methods

The mean age of the patients studied was 34, and the mechanism of injury was mostly medium to high-energy trauma, with a predominance of car accidents and falls. Fifty-nine patients (53.6%) were treated surgically and the remainder orthopedically.

Results

The complications rate was 35%.

Conclusions

Our series highlights the fact that these fractures can lead to a large number of complications, which stresses the need to gather as many multi-centric series and studies that can help the orthopedic community increase their experience of both the surgical management and the evolution of these fractures.