Objective To analyze the clinical features and treatment effect of femoral intertrochanteric fractures combined with ipsilateral pelvic and/or acetabular fractures.Methods The data of 15 patients with intertrochanteric fractures of femur com-bined with ipsilateral pelvic and/or acetabular fractures treated in Cangzhou Hospital of Integrated TCM-WM·Hebei from Oc-tober 2020 to September 2022 were retrospectively analyzed.Gender,age,fracture sides,causes of injury,Evens classification of femoral intertrochanteric fracture,Tile classification of pelvic fracture,Judet-Letournel classification of acetabular fracture,combined injuries,treatment methods,time from injury to surgery,follow-up time and Harris scores of the injured hip at the last follow-up were recorded to summarize the clinical features,treatment methods and therapeutic effects of this rare and complex fracture.Results Femoral intertrochanteric fractures with ipsilateral pelvic and/or acetabular fractures accounted for 1.19％(15/1 260)of intertrochanteric femoral fractures in the same period,including 12 males(80.00％)and 3 females(20.00％),aged 23-79 years,with an average age of 54.13 years.Fracture side:8 cases(53.33％)on the left side and 7 cases(46.67％)on the right side.The causes of injury were:10 cases(66.67％)of falling from height,2 cases(13.33％)of falling from flat ground,2 cases(13.33％)of traffic accidents,1 case(6.67％)of injury from heavy objects.Except for 2 cases of flat fall injury,the other 13 cases all combined with some kinds of other injuries.According to Evens classification,there were 2 cases of type Ⅲ(13.33％),2 cases of type Ⅳ(13.33％)and 11 cases of type V(73.33％).There were 9 cases of pelvic fractures,4 cases of acetabular frac-tures,and 2 cases of both pelvic and acetabular fractures.Pelvic fractures were classified according to Tile classification:type A(2 cases)(18.18％),type B(2 cases)(18.18％),type C(7 cases)(63.64％).According to Judet-Letournel classification,there were 3 anterior wall fractures(50.00％),1 anterior column fracture(16.67％),1 posterior column fracture(16.67％),and 1 posterior wall fracture(16.67％).After excluding two patients without operation,13 patients received surgeries for intertrochanteric or pel-vic/acetabular fractures after an average waiting time of 6 days(0-12 days).Intertrochanteric fractures of femur were all treated with intramedullary fixation,and pelvic/acetabular fractures were fixed with plate in 2 cases and external fixation in 3 cases.The rest were treated conservatively.Thirteen patients were followed up for 13 to 29 months(mean 21.50 months).The Harris score was 49 to 94(mean 82.00).Conclusion The incidence of intertrochanteric fracture of femur combined with ipsilateral pelvic and/or acetabular fracture is low.This kind of fracture is often a complex fracture caused by high-energy injury,and most of the patients are male.It should be comprehensively evaluated before surgery,and the appropriate surgical timing,incision and fixa-tion methods should be selected according to the overall condition of the patients.The short-term postoperative effect is good.
Intertrochanteric fracture of femurPelvic fractureAcetabular fractureIpsilateral
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