Abstract: Aims & Objectives:
To analyse the operative results of acetabulum fracture with respect to operative technique, clinical and radiological union, time for mobilisation, complications and functional outcome measured by Merle d’Aubigne score and Harris Hip score at the end of follow up.
Materials: 26 patients with acetabulum fracture treated by open reduction and internal fixation were included in the study and evaluated for 2 years between 2013 to 2016. The ages of patients ranged from 21 to 56 years. Elementary fractures had more incidence than associated fractures out of which transverse type and both column type had similar incidences i.e. 15%. 55% of the patients were treated with Kocher Langenbeck’s approach and ilioinguinal approach was used in 40% patient. The average follow up duration was 1.8 years ranging from a minimum of one year to maximum of three years.
Results and Observation: In 14 (70%) of the patients radiological union was seen in 4-5 months of surgery. Operative outcome of present study as per Merle d’ Aubigne scoring system shows excellent to good result in 17 (85%) of patients and fair to poor result in 3(15%) of patients. In the present study 18 (90%) patients had flexion of more than 90 degrees and 15 (75%) patients had extension of more than 10 degrees. Abduction and adduction of more than 20 degrees and more than 10 degrees was seen in 17 and 18 patients respectively. The internal and external rotation was more than 15 degrees in 14 and 15 patients respectively.
Conclusion: The most common cause of acetabular injury is vehicular accidents and occur in young and active men. The most common type of fracture pattern is posterior wall and then transverse with posterior wall. Kocher Langen beck’s approach gives good results for posterior wall involvement and ilio-inguinal approach is excellent for anterior column and anterior wall-posterior hemi transverse fracture. Result of surgery of acetabulum fracture is directly proportional to amount of initial trauma, surgeon’s experience and skill.