Pediatric and Adolescent Fractures of the Acetabulum Treated With ORIF: What Are Their Functional Outcomes?

• Published in: Journal of orthopaedic trauma Vol. 36; no. 3; p. 137
• Main Authors: Southam, Brendan R, Schumaier, Adam, Ramalingam, Wendy, Avilucea, Frank, Rice Denning, Jaime, Whitlock, Patrick W, Archdeacon, Michael T
• Format: Journal Article
• Language: English
• Published: United States 01.03.2022
• Subjects: Acetabulum - injuries; Acetabulum - surgery; Adolescent; Adult; Child; Fracture Fixation, Internal; Fractures, Bone - surgery; Hip Fractures; Humans; Retrospective Studies; Treatment Outcome
• ISSN: 1531-2291
• DOI: 10.1097/BOT.0000000000002248

To evaluate the functional outcomes of pediatric and adolescent patients (<18 year old) who sustained acetabulum fractures that were treated with open reduction internal fixation (ORIF). Retrospective cohort. Level 1 trauma center. Thirty-four pediatric and adolescent patients underwent acetabulum fracture ORIF between 2001 and 2018. Of the operatively treated patients, 21 patients had sufficient follow-up (>6 months), one died after fixation secondary to other traumatic injuries, and 12 patients were lost to follow-up. Acetabulum fracture ORIF. The SF-36 Health Survey and Short Musculoskeletal Functional Assessment (SMFA) were compared with population norms. The modified Merle d'Aubigné clinical hip score, Matta radiologic outcome, and postoperative complications were also documented. Functional outcome data were available at a mean of 5 years 2 months. Mean SF-36 scores were 44.8 and 50.1 for the physical component score and mental component scores, respectively, which did not differ significantly from US population norms (physical component score mean: 50, P = 0.061 and mental component score mean: 50, P = 0.973). Furthermore, the mean SMFA Bother Index score was 18.6, which is not significantly different from the population norm mean of 13.8 (P = 0.268). However, the function index mean was 31.9, which was significantly worse than the population norm mean of 12.7 (P = 0.001). Two patients with a delayed reduction (>6 hours) of an acetabulum fracture dislocation had poor outcomes related to the development of avascular necrosis and post-traumatic osteoarthritis. In this small cohort, 86% (18/21) of these patients had a favorable functional outcome with the exception of the SMFA Functional Index that was significantly less than population norms. Although long-term follow-up is needed, we advocate for operative management of pediatric and adolescent acetabulum fractures when adult displacement and instability criteria are present. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.