Acetabular Fractures: Review of 50 Consecutive Cases

Abstract

The outcome of management of 50 consecutive cases (43 males, 7 females, mean age 36.2 years) of acetabular fractures (AF) managed by the authors over a 15 year period are described. Twenty five cases were managed conservatively with bed rest, traction for 1 to 2 weeks and mobilisation with crutches nonweight bearing for at least three weeks. For those who had surgery, the operative approach consisted of non-extensile Kocher-Langenbeck (24 cases) and ilioinguinal in 1 patient. The indications for surgery included any of the following: displacement > 2mm, intra-articular fragment, posterior dislocation or luxation of femoral head and insufficient roof arc for further reconstructive surgery. The main pre-operative complication was sciatic nerve palsy (4 cases). Post-operative complications were uncommon: infected haematoma, common iliac vein laceration, heterotopic ossification, 1 each. It was observed that automobile accident (RTA) was the main aetiologic factor (86%), and males outnumber females in a ratio of 8.5:1. Conservative management proved effective for undisplaced AF, and a non-extensile operative procedure resulted in excellent reduction and reduced morbidity in severely displaced AF. Keywords : acetabular fracture, operative management, acetabular fracture Nigeria Journal of Orthopaedics and Trauma Vol. 7 (2) 2008: pp. 40-44