No abstract

We treated 54 patients with complex acetabular fractures by single ilioinguinal approach, open reduction and internal fixation using plate osteosynthesis for anterior column and lag screw for posterior column through anterior approach and prospectively followed them up for a mean period of 10.50 years (minimum 3 and maximum 27 years). We assessed patients during their serial follow-up using Harris hip score , Merle De Aubigne and Postel scrore. We correlated our results with Matta's radiological fracture reduction criteria. All patients achieved union. Reduction achieved was poor in 13%, imperfect in 33.7% and anatomical in 53.3% patients. Our mean Harris hip score and Merle de Aubigne score at mean follow up improved from19.22 & 2.57 to 85.78 & 15.6 at end of mean follow up of 10.5 years. There were 2 cases of infection and 2 cases required revision and conversion to the conventional anterior + posterior approach. There were two cases of secondary osteoarthritis of hip in patients with poor reduction. With our study we conclude that ilioinguinal approach with anterior column plating and lag screws for posterior column anteriorly offers good functional, clinical and radiological outcome for complex acetabular fractures .It must be used in experienced hands and patients selection is key to success. Comminuted posterior column fracture or fractures with more comminuted posterior column as compared to anterior column must be dealt with posteriorly. Aim must be to achieve anatomical reduction radiologically for better functional results.

IntroductionPelvic injuries account for 2% of all orthopedic admissions and are associated with high mortality rates. They need a stable fixation and not an anatomical fixation. Hence, the role of internal fixation (INFIX) comes into play, which provides a stable internal fixation without the complication of open reduction and external fixation with plates and screws. Materials and methodologyThirty-one patients with unstable pelvic ring injuries coming to a tertiary care hospital in the state of Maharashtra, India, were selected retrospectively. They were operated on with INFIX. Patients were followed up for a period of six months and evaluated according to the Majeed score. ResultsThere was a significant functional outcome in patients operated on with INFIX in pelvic ring injuries in terms of the ability to sit, stand, rejoin work, take part in sexual intercourse, and bear pain. An average Majeed score of 78 with signs of a stable bony union by six months and a full range of motion was noticed in most patients with no problems in day-to-day work. ConclusionINFIX provides stable internal fixation of pelvic fractures with good functional outcome without the disadvantages of external fixation or open reduction with plates.