Actual features of express diagnostic of acetabular fractures. Part III. Atypical fractures diagnostic algorithm. Associated local injuries
- Authors: Stoyukhin S.S.1, Lazarev A.F.2, Gudushauri Y.G.2
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Affiliations:
- City clinical hospital No. 15. O.M. Filatov
- National medical research center for traumatology and orthopedics N.N. Priorova
- Issue: Vol 27, No 1 (2020)
- Pages: 91-97
- Section: Articles
- URL: https://journals.rcsi.science/0869-8678/article/view/25890
- DOI: https://doi.org/10.17816/vto202027191-97
- ID: 25890
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Abstract
Authors shows atypical fracture patterns and rational algorithm for express diagnostic of this fractures. Associated local injuries are described.
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##article.viewOnOriginalSite##About the authors
S. S. Stoyukhin
City clinical hospital No. 15. O.M. Filatov
Author for correspondence.
Email: sergey.stoyukhin@gmail.com
Russian Federation, Moscow
A. F. Lazarev
National medical research center for traumatology and orthopedics N.N. Priorova
Email: sergey.stoyukhin@gmail.com
Russian Federation, Moscow
Yu. G. Gudushauri
National medical research center for traumatology and orthopedics N.N. Priorova
Email: sergey.stoyukhin@gmail.com
Russian Federation, Moscow
References
- Judet R, Judet J, Letournel E. Fractures of the acetabulum: Classification and surgical approaches for open reduction. J BoneJointSurg [Am]. 1964;46А(8):1615-1675.
- Beaule PE, Dorey FJ, Matta JM. Letournel classification for acetabular fractures assessment of interobserver and intraob- serverreliability J Bone Joint Surg [Am]. 2003;85-A(7):1704-1709.
- Школьников Л.Г., Селиванов В.П., Цодыкс В.М. Повреждения таза и тазовых органов. М.: Медицина; 1966.
- Лазарев А.Ф. Оперативное лечение повреждений таза: Дис. д-ра мед. наук. М. 1992.
- Anglen JO, Burd TA, Hendricks KJ, Harrison P. The «Gull Sign»: a harbinger of failure for internal fixation of geriatric acetabular fractures. JO rthop Trauma. 2003;17(9):625-634.
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Fig. 1.a - plain radiography of the pelvis upon admission; b - the first stage of determining the atypical T-shaped fracture associated with a fracture of the posterior wall; c - the second stage of determining the atypical T-shaped fracture associated with a fracture of the posterior wall; c - the final definition of an atypical T-shaped fracture associated with a fracture of the posterior wall; d, e, f, g, h - detailing of an atypical T-shaped fracture associated with a fracture of the posterior wall using targeted radiographs in the iliac and obturator projections and computed tomography.
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Fig. 2.a - plain radiography of the pelvis upon admission; b - the first stage of determining an atypical fracture of the quadrilateral plate; c - the final definition of an atypical fracture of the quadrilateral plate; d, e - detailing the fracture of the four-sided plate using sighting radiographs in the obturator and iliac projections.
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4.
Fig. 3.a - plain radiography of the pelvis upon admission; b - the first stage of determining an atypical extra-articular fracture of the anterior column; c - the second stage of determining the atypical extra-articular fracture of the anterior column; d, e, f, g - verification of an extra-articular fracture of the anterior column using sighting radiographs in the oblique-iliac and oblique-obturator projections and computed tomography.
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Fig. 4.a, b - fracture of the acetabulum on the left; C - comminuted character of the fracture of the posterior wall of the acetabulum.
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Fig. 6.a-d. The presence of shadows of bone density in the projection of the joint space (intra-articular fragments); c, d - verification of the presence of intra-articular fragments according to CT data.
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Fig. 7. Impressional fracture of the head in combination with a fracture of the posterior column (a, b).
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Fig. 8. Impressional fracture of the femoral head according to CT data in the absence of signs of head damage according to X-ray data (a, b).
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