Abstract
BackgroundUnfavorable reduction is considered one of the key factors leading to joint degeneration and compromised clinical outcome in acetabular fracture patients. Besides the columns, walls, and superior dome, the postoperative position of hip joint center (HJC), which is reported to affect hip biomechanics, should be considered during the assessment of quality of reduction. We aimed to evaluate the radiographic restoration of HJC in acetabular fractures treated with open reduction and internal fixation.MethodsPatients with a displaced acetabular fracture that received open reduction and internal fixation in the authors’ institution during the past five years were identified from the trauma database. The horizontal and vertical shifts of HJC were measured in the standard anteroposterior view radiographs taken postoperatively. The radiographic quality of fracture reduction was graded according to Matta’s criteria. The relationships between the shift of HJC and the other variables were evaluated.ResultsTotally 127 patients with 56 elementary and 71 associated-type acetabular fractures were included, wherein the majority showed a medial (89.0%) and proximal (93.7%) shift of HJC postoperatively. An average of 2.8 mm horizontal and 2.2 mm vertical shift of HJC were observed, which correlated significantly with the quality of fracture reduction (P < 0.001 for both). The horizontal shift of HJC correlated with the fracture type (P = 0.022).ConclusionsThe restoration of HJC correlates with the quality of reduction in acetabular fractures following open reduction and internal fixation. Further studies are required to address the effects of HJC shift on the biomechanical changes and clinical outcomes of hip joint, especially in poorly reduced acetabular fractures.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-277) contains supplementary material, which is available to authorized users.
Highlights
Unfavorable reduction is considered one of the key factors leading to joint degeneration and compromised clinical outcome in acetabular fracture patients
Following well-planned open reduction and internal fixation (ORIF), a good to excellent result can be estimated in a large part of the patients with acetabular fractures
We retrospectively reviewed the patients with acetabular fractures that were recorded in the trauma database in the authors’ department
Summary
Unfavorable reduction is considered one of the key factors leading to joint degeneration and compromised clinical outcome in acetabular fracture patients. We aimed to evaluate the radiographic restoration of HJC in acetabular fractures treated with open reduction and internal fixation. Following well-planned open reduction and internal fixation (ORIF), a good to excellent result can be estimated in a large part of the patients with acetabular fractures. Post-traumatic osteoarthritis, usually accompanied with loss of hip motion and increase of pain, has been considered one of the most common complications associated with compromised outcomes in acetabular fractures [3]. It’s generally accepted that biomechanical alterations in hip joint, caused by an unfavorable fracture reduction, play undoubtable roles in the development of arthritis. Special emphases were placed to analyze the changes of intraarticular contact characteristics and the loss of stability after acetabular fractures [4,5]
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