Objective To discuss operative treatment method for displaced acetabular fractures so as to improve the curative effects.Methods A retrospective study was done on data of 46 patients with displaced acetabular fractures treated operatively from June 2000 to September 2008.According to Letournel-Judet classification,there were eight patients with posterior column fractures combined with posterior walk fractures,four with anterior column fractures combined with posterior wall fractures,11 with transverse fractures combined with posterior wall fractures,eight with type T fractures and 15 with doublecolumn fractures.All patients were treated with open reduction and internal reconstructive plate fixation through Kocher-Langenbeck,iloinguinal or anteroposterior approaches respectively.Results All patients were followed up for 6 months to 8 years(average 3.9 years).According to modified Merle d' Aubigne and Postel score criteria,the result was excellent in 23 patients,good in 14,fair in 7 and poor in 2,with excellence rate of 80%.Postoperative complications included fat liquefaction in two patients(4%),iatrogenic sciatic nerve injury in two(4%),femoral head necrosis in three(7%),heterotopic ossification in three(7%)and traumatic arthritis in four(9%),with no operative death or nonunion occurred.Conclusions Preoperative accurate assessment of fracture type and displacement direction,appropriate selection of operation time and surgical approach as well as good operative reduction and internal fixation are key to providing satisfactory outcome for displaced acetabular fractures.

BACKGROUNDIt is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention. The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.

METHODSBlood samples of eight patients were taken before the first exposure to ionizing radiation, 10 minutes, 20 minutes, 30 minutes, 1 hour, and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics. Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group. Blood samples were taken before coronary angiography and 15 minutes after the last exposure. By enumerating γ-H2AX foci, the impact of prolonging the interval on DNA double-strand breaks was investigated. Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.

RESULTSAn increase in foci was found in all patients received percutaneous coronary intervention. The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure. There was no statistically significant difference between the two groups in γ-H2AX foci at baseline. On average there were (0.79 ± 0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66 ± 0.21) in the intermittent radiation exposure group after exposure (P < 0.05).

CONCLUSIONSA significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures. The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.

Adult ; Coronary Angiography ; adverse effects ; DNA Breaks, Double-Stranded ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Humans ; Lymphocytes ; metabolism ; radiation effects ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects