Abstract

Background: Dislocated BB fractures and multi-plane fractures are subject to surgical treatment. Open reduction and internal fixation (in foreign literature, the abbreviation ORIF is used-open reduction and internal fixation) remain the standard method of treating fractures of the BB to date. Many authors, in cases of fractures that are predictors of poor results of ORIF use, recommend performing “acute” PE TBS, which, according to the authors, is a “viable long-term solution” to the problem of fracture treatment, especially in elderly patients. Aim. To carry out anatomical and radiological characterization of fractures in order to optimize approaches to surgical treatment of patients and improve its results. Material and methods. For the period from 2009 to 2019 and the hospital treated 53 patients who are diagnosed with 54 fractures of Explosives. The age of the patients ranged from 18 to 71 years. Men predominated-60.4%. All patients received a high-energy injury. Fractures of the front column (29.2%) and both columns (20.4%) prevailed. In patients with BB fractures, fractures of the anterior column (29.2%) and both columns (20.4%) prevailed. Transverse, T-shaped, T-shaped with central dislocation of the hip, anterior column, anterior wall, semi-transverse fracture of the posterior column, fracture of both columns with central dislocation of the hip were detected with approximately equal frequency. Dislocation of the femur was diagnosed in 12 cases (22.2%), half of them had posterior dislocation. GBC damage was detected in 12 cases. Results and discussion. The analysis of the results of X-ray and CT examination of patients allowed us to detail the anatomical and morphological nature of fractures and injuries of the BB and GBC. Patients with BB fractures were divided into two clinical groups, taking into account the nature of anatomical and morphological injuries of the BB and femoral head. Criteria for inclusion and exclusion of patients in clinical groups have been developed. Indications for the choice of the most optimal variant of the surgical treatment method for each individual patient in each clinical group are determined. In the first group of patients, ORIF was performed using standard surgical approaches and submerged fixators or performing percutaneous minimally invasive fracture fixation. In the second group of patients, CHP is indicated. In older patients, preference should be given to performing “acute” PE TBS. Conclusion. The detailing of anatomical and morphological injuries and fractures of the BB and GBC allowed us to identify the features of these injuries, which contributed to the formation of two clinical groups of patients with different types of BB fractures. Criteria for inclusion and exclusion of patients in clinical groups were developed. Hikes have been developed for each clinical group and indications for choosing the most optimal variant of the surgical treatment method have been determined.

Abbreviations:Acetabulum fractures and their classification; Open reposition and internal fixation; Acute primary hip replacement