Abstract
IntroductionFor decades, acetabular fractures were treated conservatively. Judet et al. in 1960s established the operative treatment of these fractures by continuous improvement of pre-operative evaluation and classification of fractures. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcome.Case SeriesWe report 67 consecutive patients who underwent surgical treatment for acetabular fracture; 44 patients were available for follow-up. In 35 (79.5%) cases, congruent reductions were achieved. The final mean Harris hip score was 81.8 (53-95). Functional outcomes according to Harris score were excellent and good in 31 patients (70.5%).ConclusionsThe results of internal fixation of displaced acetabular fractures in our series were satisfactory.
Highlights
Several studies demonstrated that accurate reduction and rigid internal fixation can decrease the incidence of post-traumatic arthritis and improve functional outcome [4,5,6]
Surgical criteria were acetabular fractures with 2 mm or more displacement in the dome area of the acetabulum, roof arc angle measurement of less than 45 degrees, presence of intra-articular fragments, posterior joint instability, irreducible fracture/dislocations and the need to reconstruct the socket for total hip replacement. 4 cases died due to poor general health and associated injuries and 19 cases were lost to follow-up
Functional outcomes according to Harris score were excellent or good in 31 patients (70.5%) (Table 2), poor in 5 patients (11.4%) with mean Harris score = 59, all of which had incongruent reduction
Summary
Fractures of acetabulum and pelvis constitute only 2% of all fractures [1, 2] but they are associated with significant morbidity and mortality due to associated injuries [3]. Several studies demonstrated that accurate reduction and rigid internal fixation can decrease the incidence of post-traumatic arthritis and improve functional outcome [4,5,6]. Poor bone stock in older patients, comminuted articular surface fractures and poly-trauma patients with multiple co-morbidities are adverse factors influencing outcome [7]. Current trends in the treatment of these fractures include open reduction and internal fixation [8] according to the principles that apply to all inta-articular injuries. Results (19962010) and functional outcome of surgical treatment of Article type: Case Report; Received: 09 Jul 2012; Revised: 12 Aug 2012; Accepted: 31 Dec 2012; Epub: 26 May 2013; Ppub: Spring 2013. Implication for health policy/practice/research/medical education: The results of the current study and other similar studies can improve the management of acetabular fractures. Surgical Management of Acetabular Fractures: A Case Series.
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