Fucntional and Radiological Outcome of Surgical Management of Acetabular Fractures in Tertiary Care Hospital

Abstract

PurposeAcetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital.Materials and MethodsTotal 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014. Patients were evaluated clinically with Harris hip score (HHS) and radiologically with Matta outcome grading. The factors examined include age, gender, fracture pattern, time between injury and surgery, initial displacement and quality of reduction on the final outcome.ResultsThere were 34 males and 16 females. Mean age was 44.20±11.65 years while mean duration of stay was 9.28±2.36 days. Duration of follow-up was 24 months. Most common mechanism of injury was motor vehicle accident (n=37, 74.0%). Open reduction and internal fixation of fractures were performed using reconstruction plates. Mean HHS at 24 months was 82.36±8.55. The clinical outcome was acceptable (excellent or good) in 35 (70.0%) cases and not acceptable (fair or poor) in 15 (30.0%) cases. The radiological outcome was anatomical in 39 (78.0%) cases, congruent in 5 (10.0%) cases, incongruent in 6 (12.0%) cases.ConclusionStudy results indicated that mechanism of injury, time between injury and surgery, initial degree of displacement and quality of reduction had significant effect on functional as well as radiological outcome.

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

“…However, fractures of the acetabulum continue to be a challenge for orthopedic surgeons. The surgery is complex and demanding even for the experienced surgeon [ 3 ]. Stable and anatomic fixation for fractured posterior wall and column can provide hip stability.…”

Clinico-radiological Outcomes of Using Modified Stoppa Approach for Treating Acetabular Fractures: An Institutional Review

“…Acetabulum fractures are on the rise in developing countries, unlike in the western world where they have reached a plateau [12][13]. These fractures require absolute reduction to attain the best results as the hip joint is the major weight-bearing joint of the body [1][2].…”

“…Letournel et al proposed that surgical management had a better outcome than the conservative approach [1]. However, the major challenge in developing countries, including India, is the lack of appropriately trained acetabular surgeons to address these complex injuries [12,14]. Less experienced surgeons often try to manage these fractures conservatively or refer them to other surgeons.…”

“…We measured the functional outcomes using both HHS and modified NMAPS, in contrast to other studies, for higher inter-evaluator reliability [11]. When patients were grouped as acceptable and non-acceptable, we had a functional outcome of 74% in the HHS and 79% in NMAPS groups [12].…”

Outcome of surgical treatment for displaced acetabular fractures: a prospective study

“…They need more skills to be handled. They are more complex injuries as compared to other parts of body 8 . Most acetabular fractures are treated with surgery.…”