Functional and radiological outcome of acetabular fractures and the factors affecting the outcome

Badami, Ramachandra N; Shetty, M. Shantharam; Kumar, Manoj

doi:10.22271/ortho.2017.v3.i4e.42

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…ORIF is the gold standard treatment for displaced acetabular fractures. The quality of reduction achieved is recorded by the Matta grading score, which describes the postoperative step-off in the joint in Grade 1 (anatomical reconstruction: < 2 mm), Grade 2 (imperfect reduction: 2 – 3 mm), and Grade 3 (poor reduction > 3 mm) [ 3 , 19 , 28 , 37 , 48 ].…”

Section: Introductionmentioning

confidence: 99%

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Navas

Mengis

Zimmerer

et al. 2022

BMC Musculoskelet Disord

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Background Pelvic fractures are often associated with spine injury in polytrauma patients. This study aimed to determine whether concomitant spine injury influence the surgical outcome of pelvic fracture. Methods We performed a retrospective analysis of data of patients registered in the German Pelvic Registry between January 2003 and December 2017. Clinical characteristics, surgical parameters, and outcomes were compared between patients with isolated pelvic fracture (group A) and patients with pelvic fracture plus spine injury (group B). We also compared apart patients with isolated acetabular fracture (group C) versus patients with acetabular fracture plus spine injury (group D). Results Surgery for pelvic fracture was significantly more common in group B than in group A (38.3% vs. 36.6%; p = 0.0002), as also emergency pelvic stabilizations (9.5% vs. 6.7%; p < 0.0001). The mean time to emergency stabilization was longer in group B (137 ± 106 min vs. 113 ± 97 min; p < 0.0001), as well as the mean time until definitive stabilization of the pelvic fracture (7.3 ± 4 days vs. 5.4 ± 8.0 days; p = 0.147). The mean duration of treatment and the morbidity and mortality rates were all significantly higher in group B (p < 0.0001). Operation time was significantly shorter in group C than in group D (176 ± 81 min vs. 203 ± 119 min, p < 0.0001). Intraoperative blood loss was not significantly different between the two groups with acetabular injuries. Although preoperative acetabular fracture dislocation was slightly less common in group D, postoperative fracture dislocation was slightly more common. The distribution of Matta grades was significantly different between the two groups. Patients with isolated acetabular injuries were significantly less likely to have neurological deficit at discharge (94.5%; p < 0.0001). In-hospital complications were more common in patients with combined spine plus pelvic injuries (groups B and D) than in patients with isolated pelvic and acetabular injury (groups A and C). Conclusions Delaying definitive surgical treatment of pelvic fractures due to spinal cord injury appears to have a negative impact on the outcome of pelvic fractures, especially on the quality of reduction of acetabular fractures.

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Section: Introductionmentioning

confidence: 99%

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Navas

Mengis

Zimmerer

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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Clinical, radiological and functional outcome following surgical fixation of acetabular fractures

Vanamail,

Vanamail

2024

IJOS

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: Acetabular fractures are commonly caused by high-velocity injuries that can result from falls from heights or motor vehicle accidents. Surgical fixation has been found to result in improved clinical outcomes such as reduced pain, improved range of motion, and improved alignment and stability of the joint. Patients with pelvic injuries often have associated multiple systemic injuries, adding to the overall morbidity and mortality. Treating fractures in the pelvic area involving the acetabulum can be complicated, significantly when displaced. Proper exposure of the acetabulum and rigid internal fixation is necessary to achieve the main goals of treatment, which are to reconstruct the articular surface and promote early mobilization. Closed methods make it nearly impossible to restore the articular surfaces completely and obtain enough stability for early hip motion.: This study assesses the functional outcome of open surgical fixation of acetabulum fractures involving single or both columns. : Our study looked at patients over 18 years old with displaced fractures, and we treated them using only two approaches: the Kocher Langenbeck approach and the Modified Stoppa approach. Radiological and functional examinations were performed monthly for the first six months. Postoperative radiological assessments were graded using Matta's criteria, and functional outcomes were assessed using modified Merle d' Aubigné and Postel Hip Score.: We treated displaced acetabular fractures using only two non-extensile approaches: the Kocher Langenbeck approach and the Modified Stoppa approach. In most cases (67%), we used only one method, except in 7 patients. Our treatment achieved an impressive 85% rate of good to excellent outcomes (18 out of 21). Our study found that the delay in surgery time significantly impacted Merle d' Aubigne scores (P<0.05), leading to complications and lower functional outcomes in complicated cases. The functional and radiological outcomes were also significantly affected by the mechanism of injury, time between injury and surgery, initial degree of displacement, and quality of reduction. Surgical fixation of displaced acetabular fractures can yield better results with good imaging facilities, experienced surgeons, better instrumentation, and good perioperative care. However, further studies with an adequate sample size are needed to validate our findings. A study on the outcome of acetabular fractures treated surgically found that early surgical intervention and good perioperative care can lead to satisfactory functional outcomes. The study used only two non-extensile approaches and achieved an 85% rate of suitable to excellent outcomes. The study also observed that the mechanism of injury, time between injury and surgery, initial degree of displacement, and reduction quality significantly affected functional and radiological outcomes. However, further studies are needed to validate the findings.

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Functional and radiological outcome of acetabular fractures and the factors affecting the outcome

Cited by 2 publications

References 26 publications

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Clinical, radiological and functional outcome following surgical fixation of acetabular fractures

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