PDF(Pubmed)
Abstract：
Preoperative management of acetabular fracture is a major problem and no consensus has been reached in literature on the optimal treatment of this problem. We present the results of the First Italian Consensus Conference on Acetabular fracture. An extensive review of the literature has been undertaken by the organizing committee and forwarded to the panel. Members were appointed by surgical experience with acetabular fractures. From November 2017 to January 2018, the organizing committee undertook the critical revision and prepared the presentation to the Panel on the day of the Conference. Then 11 recommendations were presented according to the 11 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on, a second debate took place in September 2018 to reach a unanimous consent. We present results of the following questions: does hip dislocation require reduction? Should hip reduction be performed as soon as possible? In case of unsuccessful reduction of the dislocation after attempts in the emergency department, how should it be treated? If there is any tendency toward renewed dislocation, how should it be treated? Should Computed Tomography (CT) scan be performed before reduction? Should traction be used? How can we treat the pain? Is preoperative ultrasound exam to rule out vein thrombosis always necessary? Is tranexamic acid intravenous (IV) preoperatively recommended? Which antibiotic prophylactic protocols should be used? Is any preoperative heterotopic ossification prophylaxis suggested? In this article we present the indications of the First Italian Consensus Conference: a hip dislocation should be reduced as soon as possible. If unsuccessful, surgeon may repeat the attempts optimizing the technique. Preoperative CT scan is not mandatory before reduction. Skeletal traction is not indicated in most of the acetabular fracture. Standard pain and antibiotic prophylactic protocols for trauma patient should be used. Preoperative ultrasound exam is not recommended in all acetabular fracture. Tranexamic acid should be preoperatively used. There is no indication for preoperative heterotopic ossification.
摘要：
髋臼骨折的术前处理是一个主要问题，文献中尚未就该问题的最佳治疗达成共识。我们介绍了第一届意大利髋臼骨折共识会议的结果。组委会对文献进行了广泛的审查，并提交给了小组。成员是根据髋臼骨折的手术经验任命的。从2017年11月至2018年1月，组委会进行了严格的修订，并在会议当天向小组准备了介绍。然后根据提交的11个问题提出了11项建议。小组在与听众讨论和修正后对建议进行了表决。稍后，2018年9月进行了第二次辩论,以达成一致意见.我们提出了以下问题的结果：髋关节脱位需要复位吗？应该尽快进行髋关节复位吗？如果在急诊科尝试后脱位复位不成功，应该如何治疗？如果有任何重新错位的趋势，应该如何治疗？是否应该在复位前进行计算机断层扫描（CT）扫描？是否应该使用牵引？我们如何治疗疼痛？是否必须进行术前超声检查以排除静脉血栓形成？是否建议在术前静脉注射氨甲环酸（IV）？应使用哪种抗生素预防？是否建议在术前预防异位骨化？在本文中，我们介绍了第一届意大利共识会议的适应症：应尽快减少髋关节脱位。如果不成功,外科医生可能会重复尝试优化技术。术前CT扫描在复位前不是强制性的。在大多数髋臼骨折中未显示骨骼牵引。创伤患者应使用标准疼痛和抗生素预防方案。不建议对所有髋臼骨折进行术前超声检查。应在术前使用氨甲环酸。术前异位骨化没有指征。
