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

Author(s): Dr. Ramachandra N Badami, Dr. M Shantharam Shetty and Dr. M Ajith Kumar

Abstract: Introduction: The relative infrequency and complexity of acetabular fractures provide challenge for trauma surgeons. These fractures are the result of high velocity injuries, management may be complicated by other injuries. Operative treatment has become standard for displaced acetabular fractures. Aim of treatment is to maintain a stable congruent joint.
Materials & Methods: We studied 105 closed acetabular fractures treated by various modalities from August 2009 to June 2012.Specific criteria were used to choose the treatment modality. Clinical outcome was graded using Merle D’Aubigne-Postel scoring system. Radiological outcome was evaluated by Matta’s criteria.
Results: Posterior wall fracture was most common fracture pattern followed by transverse fracture.49 patients were treated conservatively & 56 with surgical intervention. Average time to fracture union was 18 wks. We had good to excellent functional outcome in 89 patients, fair to poor results in 16 and good to excellent radiological outcome in 97 patients, fair outcome in 8. Outcome was better in patients with isolated acetabular fracture, elimentary type of fractures, those operated between 5-10days. Two patients had iatrogenic sciatic nerve injury, two had infection, three had heterotopic ossification, two had AVN of femoral head, four had OA of hip joint.
Conclusion: Conservative treatment is a safe, effective and cost-efficient treatment modality in minimally displaced fractures. Surgery provides good to excellent medium term results only if the fracture in reduced anatomically. The outcome results are influenced by the age of the patient, fracture pattern, associated injuries, delay to surgical fixation & articular cartilage damage.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4e.42