基于三柱分型的髋臼骨折精准诊疗专家共识(2023版)

Expert consensus on the accurate diagnosis and treatment of acetabular fractures based on three-column classification (version 2023)

髋臼解剖结构不规则, 周围重要的血管、神经集聚, 该部位损伤的精确分型、治疗方案的合理制订对骨科医师而言是一项巨大挑战。髋臼骨折传统Letournel-Judet分型系统应用广泛, 但存在骨折类型囊括不全、难以理解、分型对手术指导价值不足等局限性;临床上分型诊断错误、手术策略选择不当导致创伤性关节炎等严重并发症屡见不鲜, 给社会和家庭带来沉重负担。三柱分型基于解剖特点, 具有囊括骨折类型多、便于理解等优势。为解决基于Letournel-Judet分型诊疗过程中存在的问题、实现髋臼骨折患者的精准诊疗、获得满意的预后, 河北医科大学第三医院骨科创伤急救中心联合中华医学会骨科学分会创伤骨科学组组织相关领域专家, 基于循证医学原则制订《基于三柱分型的髋臼骨折精准诊疗专家共识(2023版)》, 主要结合髋臼骨折三柱分型系统, 从髋臼骨折的诊断、治疗、并发症防治等方面提出15条推荐意见, 为髋臼骨折的精准诊疗提供参考。

Accurate classification of the acetabular injuries and appropriate treatment plan are great challenges for orthopedic surgeons because of the irregular anatomical structure of the acetabulum and aggregation of important vessels and nerves around it.Letournel-Judet classification system has been widely applied to classify acetabular fractures.However,there are several limitations,including incomplete inclusion of fracture types,difficulty in understanding and insufficient guidance for surgical treatment,etc.Serious complications such as traumatic arthritis are common due to wrong classification and diagnosis and improper selection of surgical strategy,which brings a heavy burden to the society and families.Three-column classification,based on anatomic characteristics,has advantages of containing more fracture types and being easy to understand,etc.To solve the problems existing in the diagnosis and treatment process based on Letournel-Judet classification,achieve accurate diagnosis and treatment of patients with acetabular fractures,and obtain satisfactory prognosis,the Orthopedic Trauma Emergency Center of Third Hospital of Hebei Medical University and the Trauma Orthopedic Branch of the Chinese Orthopedic Association organized experts from relevant fields to formulate the Expert consensus on the accurate diagnosis and treatment of acetabular fractures based on three-column classification(version 2023)in terms of principles of evidence-based medicine.Based on the three-column classification,15 recommendations were proposed,covering the diagnosis,treatment,complication prevention and management,etc,so as to provide reference for accurate diagnosis and treatment of acetabular fractures.