Acetabulum - Predictors of postoperative outcome for acetabular fracture

Abstract

Introduction: The most prevalent type of acetabular fracture is posterior wall acetabular fracture. The conventional therapy for displaced posterior acetabular wall fractures is surgery. The clinical and radiologic results of open reduction and internal fixation in patients with posterior wall acetabular fractures are evaluated in this retrospective study. Methods: 50 patients with displaced acetabular fractures treated surgically were evaluated clinically with the Modified Postel Merle d'Aubigné score and radiologically using Matta's radiological outcome grading. The impact of age (≤ 55 or >55 years), gender, fracture displacement (≤ 20 mm or >20 mm), hip dislocation, surgical delay (≤ 2 weeks or >2 weeks), concomitant injury, and length of follow-up (≤ 2 years or >2 years) on functional outcome was studied. Results: There were 31 males (62%) and 19 females (38%), with a mean age of 38.75 years (16 to 65 years). The length of follow-up was 3 years. The Modified Postel Merle d'Aubigné score was 15.7 ± 2.2 on average (range, 8 to 18). The clinical outcome was excellent in 12 (24%) patients, good in 19 (38%), fair in 10 (20%), and poor in 9 (18%, including 10 patients who underwent THR for secondary arthritis). Initial fracture displacement >20 mm (P = 0.018), joint dislocation (P = 0.015), and surgery delay (P = 0.001), quality of reduction (P = 0.0001) and presence of related injuries (P = 0.0001) had a significant impact on the Modified Postel Merle d'Aubigné score. Age, gender, fracture type, and length of follow-up, on the other hand, had no effect on clinical outcome. Conclusion: Bad reduction, concomitant injuries, fracture displacement of more than 20 mm, joint dislocation, and late surgery all have a poor prognosis when it comes to predicting the fate of surgically treated acetabular fractures.