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Objective follow-up surgery involving the posterior wall acetabular fracture patients, assessing radiological findings and clinical efficacy, impact analysis of the clinical efficacy of the various risk factors discussed in which an independent risk factor. Methods for February 2000 to March 2006 at the First Affiliated Hospital of Soochow University orthopedic surgery involving the posterior wall acetabular fracture 64 cases were followed up study, in which a simple posterior wall fractures, 42 cases of simple posterior wall fracture 22 cases : where posterior column with posterior wall fractures in 14 cases, 8 cases of transverse with posterior wall fractures. Follow-up includes: 1, radiographic assessment: According to Matta reset standard, X-ray evaluation criteria assess the quality of fracture reduction surgery and imaging, according to Brooker classification of heterotopic ossification in patients assessed the situation; 2, clinical assessment: ⑴ respectively visual analogue scales (visual analogue scales VAS), ⑵, modified Merle d'Aubigné and Postel scoring system for evaluation. 3, may affect a number of clinical factors were analyzed: age, sex, BMI (body mass index BMI), injury to the femoral head reset time, time from injury to surgery, fracture type, edge compression fractures, fractures degree of comminuted fracture of the quality of reduction and heterotopic ossification, analysis of these factors and the relevance of the curative effect. The results were followed up 13-92 months, mean 44.6 ± 4.2 months. Matta reset according to the standard, anatomical reduction in 58 cases, 5 cases of poor reset, reset poor in 1 case. In accordance with the X-ray evaluation criteria, the final X-ray effect: excellent 52 cases, good in 4 cases, 5 cases and poor in 3 cases, good rate 87.50%. According to the modified Merle d'Aubigné and Postel scoring system, and ultimately surgery: excellent in 54 cases, 3 cases, 4 cases and poor in 3 cases, clinical excellent rate of 89.06%. Excellent rate of clinical fractures in simple and non-simple posterior wall fracture group were 97.62% and 72.72%; in anatomic and non-anatomic group were 94.83% and 33.33%; femoral head after injury to reset time lt; 24h and ≥ 24h group were 94.87% and 20.00%; after injury and surgery lt; 3w and ≥ 3w group were 94.83% and 33.33%; comminuted fracture of the posterior wall and non-comminuted fracture group were 77.78% and 97.30% ; the age lt; 50y and ≥ 50y group were 98.15% and 40.0%; heterotopic ossification in severe and mild heterotopic ossification group were 0% and 87.50%; above clinical efficacy compared by statistical analysis showed significant difference (P lt; 0.05). Gender, body mass index, margin compression fractures and other factors on the clinical efficacy had no significant effect (P gt; 0.05). The various factors affecting the multivariate Logistic regression analysis showed that the time from injury to surgery, quality of fracture reduction, severe heterotopic ossification affecting clinical efficacy in patients with an independent risk factor. CONCLUSION an anatomic reduction, firmly fixed acetabular posterior wall fractures involving the clinical efficacy satisfactory basis; 2 Reset the quality of the femoral head from injury to reset time, time from injury to surgery, fracture type, degree of comminuted fracture, age and severity vary bit ossification and other factors that affect the clinical efficacy of posterior wall fracture of the main factors. Time from injury to surgery, quality of fracture reduction, severe heterotopic ossification affecting clinical efficacy in patients with an independent risk factor, to avoid the negative factors affecting the efficacy help improve clinical efficacy.
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