髋臼四边体骨折临床诊疗指南(2023)

Clinical guideline for the diagnosis and treatment of quadrilateral plate fractures of acetabulum(2023)

随着社会人口老龄化加剧,髋臼四边体(简称“四边体”)骨折的发病率逐年升高。目前,四边体骨折的诊断率和治疗率低,已成为困扰创伤骨科医师的世界性难题,给患者、家庭和社会造成了沉重的负担,因此四边体骨折的规范化诊断与治疗对临床工作和健康中国战略具有重要意义。目前,国内外尚缺乏针对四边体骨折的系统性临床诊疗指南。经中华医学会骨科学分会、中国医师协会骨科分会骨盆髋臼学组、中国医疗保健国际交流促进会骨科分会骨盆髋臼损伤学部、湖北省中医药学会骨伤专业委员会骨盆髋臼学组批准,按照《世界卫生组织指南制订手册》的指导,确立本指南制订流程;采用德尔菲法,由临床专家共同讨论确定指南的相关临床问题,由专家组系统检索相关临床问题证据,应用牛津循证医学中心证据分级系统对相关证据进行分级,并做出相应等级推荐;最终经过专家组反复讨论,遴选出骨科医师最为关注的9个临床问题,形成9条循证医学推荐意见,供广大骨科医师在临床工作中参考应用,旨在提高四边体骨折诊疗的科学性和先进性,为患者提供安全、高效的医疗服务。

With the intensification of population aging in society,the incidence of quadrilateral plate fractures of the acetabulum is increasing year by year.Currently,the diagnosis and treatment rates of quadrilateral fractures are low,posing a global challenge for traumatic orthopedic surgeons and placing a heavy burden on patients,their families,and society.Therefore,standardized diagnosis and treatment of quadrilateral plate fractures are of significant importance to clinical work and the Healthy China Initiative.Currently,there is a lack of systematic clinical guidelines for quadrilateral plate fractures domestically and internationally.Approved by the Chinese Orthopaedic Association,the Group of Pelvic&Acetabular of Chinese Association of Orthopaedic,the Group of Pelvic&Acetabular Injury of Orthopaedic Branch of China International Exchange and Promotive Association for Medical and Health Care,and the Pelvis&Acetabular Group of the Orthopaedics&Traumatology Professional Committee of Hubei Association of Chinese Medicine,the process for developing this guideline is established in accordance with the guidance of the WHO Handbook for Guideline Development.The Delphi method is employed,and clinical experts collectively discuss and determine the relevant clinical issues for the guidelines.The expert group systematically searches for evidence related to the clinical questions.The evidence is graded using The Oxford Levels of Evidence from the Oxford Center for Evidence-Based Medicine,and corresponding level recommendations are made.Finally,after repeated discussions by the expert group,nine clinical questions that orthopedic surgeons are most concerned about are selected,forming nine evidence-based recommendations for reference and application in the clinical practice.The aim is to enhance the scientific and advanced nature of the diagnosis and treatment of quadrilateral plate fractures and provide patients with safe and efficient medical services.