Current trends in the surgical treatment of patients with pelvic and acetabular injuries(literature review)

Zagorodny N.V., Kolesnik A.I., Lazarev A.F., Solod E.I., Ochkurenko A.A., Bukhtin K.M., Sergeev S.V., Shesternya N.A., Donchenko S.V., Dorokhin A.I.

Abstract


Introduction
There is evidence in the literature over the past 5 years that pelvic and acetabular fractures are increasing in prevalence with the rise of injuries sustained in road traffic accidents, the growing number and severity of trauma, significant complication rate and unsatisfactory outcomes due to untimely surgical treatment.
Objective
Review current trends in the selection of surgical approaches and fixation of the pelvis and acetabulum, the postoperative rehabilitation strategies and identify factors for poor outcomes of surgical treatment.
Material and methods
We performed searches using HAC peer-reviewed and SCOPUS indexed journals, EMBASE, MEDLINE, Сochrane library, еLibrary.ru, Wiley Online Library with search criteria of pelvic fractures, displaced acetabular fractures, open reduction of the pelvis and acetabulum, osteosynthesis, minimally invasive osteosynthesis and primary total hip arthroplasty, approaches and complications of acetabular fracture surgery.
Results
Indications to surgical treatment of patients with concomitant, multiple and isolated fractures of the pelvis and acetabulum were identified with the use of current strategy and principles of damage control surgery and damage control orthopaedics. Surgical approaches for two-column acetabular fractures have been shown to be extensile and traumatic.
Discussion
Most authors report use of the active surgical strategy for displaced fractures of the pelvis and acetabulum. Open reduction internal fixation is the standard of care for pelvic and acetabular fractures.
Conclusion
Postoperative complications and long term rehabilitation of patients with pelvic and acetabular fractures support further research and development of new more effective approaches to address the solution of the challenging issue.

Keywords


osteosynthesis, minimally invasive osteosynthesis, primary total hip arthroplasty, surgical treatment, acetabular fracture

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DOI: http://dx.doi.org/10.18019/1028-4427-2020-26-2-266-274

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