Fractures of the Acetabulum

At the request of our publishers, I accepted the task of preparing this second edition. I felt this was necessary for several reasons: new imaging technologies such as CT scanning and 3-D reconstructions are now used routinely, the in dications for employing improved approaches are clearer, and reconstructions are facilitated by new internal fixation devices. Above all, I thought it was time to report the long-term results of the 940 acetabular fractures, 90070 of which were treated surgically - a unique series. In spite of the experience acquired from the three previous reviews of cases (1966, 1971, and 1978), I failed to foresee the amount of time this revision would need. In fact, it took more than 3 years to follow up the larger number of cases, and 159 patients (out of 800, i. e. 22. 7%) were not included as they had moved since their last review and simply could not be located. At a time when it is in fashion to evaluate the cost of health care, it is strange to see how public administrators, so keen on evaluating the immediate cost of our opera tions, do not care about the quality of their long-term results, which appears to us, however, to be the best basis for the choice of the initial treatment.

Klappentext

This book was written to help orthopaedic and traumasurgeons understand andtreat acetabular fractures, layingout a method of reading both plain radiographs and CT scans.Starting from a perfect anatomical understanding of eachfracture, readers are then shown in detail how to choose themost appropriate treatment and, in particular, the bestapproach foreach. The possible complications of surgery,especially ectopic bone formation, and the way to preventand deal with them are fully covered.A detailed account is given of the long-term results (3-30years post-injury) in 569 cases operated on within 21 daysof injury, 157 operated on at between 3 weeks and 4 months,and 91 cases in which operative reconstruction was delayedstill longer.A self-trainingchapter on the interpretation of radiographscompletes the book.This second edition of "Fractures of the Acetabulum" hasbeen greatly expanded from the first, with comprehensivecoverage of two- and three-dimensional CTscanning, many newdetails on surgical approaches and techniques, and a fullanalysis of the results of surgical treatment of 869operated casesfrom among the 940 cases (updated from 469 inthe first edition) included inthe book: the largest seriesever published of acetabular fractures operatedupon by thesame surgeon.Dr. Letournel considers that a trauma surgeon facing anacetabular fracture has to be able to answer one question:Does this fracture need surgical treatment or not?To answer that question the surgeon has to:1. Gain a complete understanding of the anatomical type ofthe fracture2. Accurately assess the displacement involved3. Take into account the associated lesions and the age ofthe fracture

Inhalt
Introduction: History and Development of Our Methods of Classification and Treatment of Acetabular Fractures.- 1 Anatomy of the Acetabulum.- 2 Mechanics of Acetabular Fractures.- 3 Radiology of the Normal Acetabulum.- 4 Classification.- 5 Posterior Wall Fractures.- 6 Fractures of the Posterior Column.- 7 Anterior Wall Fractures.- 8 Fractures of the Anterior Column.- 9 Pure Transverse Fractures.- 10 T-shaped Fractures.- 11 Associated Posterior Column and Posterior Wall Fractures.- 12 Associated Transverse and Posterior Wall Fractures.- 13 Associated and Posterior Hemitransverse Fractures.- 14 Associated Both-Column Fractures.- 15 Transitional and Extra-articular Forms.- 16 Associated Injuries.- 17 Distribution of the Clinical Series.- 18 Clinical Presentation.- 19 General Principles of Management of Acetabular Fractures.- 20 Surgical Approaches to the Acetabulum.- 21 Operative Treatment of Displaced Fractures Within Three Weeks of Injury.- 22 Operative Treatment of Specific Types of Fracture.- 23 Anatomical Results of Operation Within Three Weeks After Injury.- 24 Early Complications of Operative Treatment Within Three Weeks of Injury.- 25 Late Complications of Operative Treatment Within Three Weeks of Injury.- 26 Clinical and Radiological Results of Operation Within Three Weeks of Injury.- 27 Reassessment of Patients Treated Operatively Within Three Weeks of Injury.- 28 Operative Treatment Between Three Weeks and Four Months After Injury.- 29 Operative Treatment More Than Four Months After Injury.- 30 Exercises in Radiographic Diagnosis.