Abstract：Objective To investigate relationship between start time of postoperative ambulation (partial weight bearing) and hip joint function rehabilitation in patients with acetabular and ipsilateral femoral fractures by studying the late hip joint function. Methods The study involved 37 patients with acetabular and ipsilateral femoral fractures treated from January 2007 to June 2011, including 16 patients with associated femoral head fractures, 17 femoral shaft fractures, two greater trochanteric fractures, and two distal femoral fractures. According to the starting time of postoperative ambulation (partial weight bearing), the patients were divided into three groups, ie, Group A (≤2 months), Group B (≤3 months) and Group C (＞3 months). Harris score system was used to evaluate late hip function of the patients. Further, differences of Harris excellent-good rate among groups were analyzed. Results All patients were followed up for 14-66 months (mean 44.9 months). Fractures were all healed based on postoperative examination. Excellent-good rate of hip function was 87% (13/15) in Group A, 42% (5/12) in Group B, and 40% (4/10) in Group C, with significantly superior results in Group A than that in Groups B and C (P<0.05). Conclusions Stable internal fixation and early postoperative ambulation (partial weight bearing) favors hip function rehabilitation in patients with acetabular and ipsilateral femoral fractures. Patients who start ambulation (partial weight bearing) within two months after operation obtain better hip function recovery than those who start ambulation two months later.
CHEN Xiao,ZHANG Qi,CHEN Wei et al. Effect of postoperative ambulation starting time on outcome of patients with acetabular fractures combined with ipsilateral femoral fractures[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(5): 420-424.
［2］Zhang YZ. Clinical epidemiology of orthopedic trauma.1st ed. Stuttgart & New York: Thieme, 2012:158-350.
［3］Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction-preliminary report. J Bone Joint Surg (Am), 1964, 46:1615-1646.
［4］Moed BR, Carr SE, Watson JT. Open reduction and internal fixation of posterior wall fractures of the acetabulum. Clin Orthop Relat Res, 2000, (377): 57-67.
［6］Giannoudis PV, Nikolaou VS. Surgical techniques — How do I do it? Open reduction and internal fixation of posterior wall fractures of the acetabulum. Injury, 2008, 39:1113-1118.
［7］Farcy JP, Moskovich FR, Leonardi L. Management of acetabular fractures. Bull N Y Acad Med, 1988, 64 (4):327-334.
［8］Furey AJ, Karp J, O’Tool RV. Does early fixation of posterior wall acetabular fractures lead to increased blood loss? J Orthop Trauma, 2013, 27(1):2-5.
［9］Kim HT, Ahn JM, Hur JO, et al. Reconstruction of acetabular posterior wall fractures. Clin Orthop Surg, 2011, 3(2):114-120.
［10］φ vre S, Madsen JE, Rφise O. Acetabular fracture displacement, roof arc angles and 2 years outcome. Injury, 2008, 39:922-931.
［11］Kumar A, Shah NA, Kershaw SA, et al. Operative management of acetabular fractures. A review of 73 fractures. Injury, 2005, 36(5):605-612.
［12］Triantaphillopoulos PG, Panagiotopoulos EC, Mousafiris C, et al. Long-term results in surgically treated acetabular fractures through the posterior approaches. J Trauma, 2007, 62(2):378-382.
［14］Griffin DB, Beaulé PE, Matta JM. Safety and efficacy of the extended iliofemoral approach in the treatment of complex fractures of the acetabulum. J Bone Joint Surg (Br), 2005, 87(10):1391-1396.
［18］Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg, 1999, 7 (2):128-141.
［19］Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg (Am), 1996, 78 (11):1632-1645.
