Prospective study of functional outcome in surgical management of posterior column or posterior wall of acetabular fracture by open reduction and internal fixation

Abstract

Background: Acetabular fractures remain one of the most difficult Orthopaedic injuries to treat successfully. 80% of the acetabular fractures result from high-energy trauma like motor vehicle accidents and 10% falls from a significant height. Posterior wall fracture with or without dislocation are the most common type acetabular fracture accounting for a quarter to a third of all acetabular fractures. Unsatisfactory clinical results occur in more than 80% of patients treated non-surgically. Recently it has become obvious that accurate reduction of fracture is an important factor in achieving satisfactory outcome and open reduction is better than closed reduction Operative management usually offers the best chance of preserving long-term joint function and early mobilization but only if an anatomically reconstructed acetabulum is achieved. Material and Methods: This is a Prospective Study of 20 Patients with posterior wall or posterior column acetabular fracture treated surgically with open reduction and internal fixation with plates and screws by Kocher Langhenbeck approach. The present study was conducted in the department of Orthopaedics at Sanjay Gandhi Institute of Trauma and Orthopaedic and followed up for a period of 18 months. Results: The mean follow up period ranged from 6 weeks to 18 months. All the fractures were united at an average of 16 weeks and mean Harris hip score at the end of 1 year was 85.8. There was 1 superficial wound infections which was treated with intravenous antibiotic and wound healed with secondary intention and 1 case had foot drop post-operatively treated with foot drop splint recovery occurred after 6 month postoperatively. Conclusion: Good to excellent results were achieved in 75% of total cases. Hence we conclude that management of posterior wall or posterior column of Acetabular fracture is best achieved by means surgical approach by open reduction internal fixation with plates and screws.