Predictors of postoperative outcome for acetabular fractures

• Published in: Orthopaedics & traumatology, surgery & research Vol. 99; no. 8; pp. 929 - 935
• Main Authors: Meena, U.K, Tripathy, S.K, Sen, R.K, Aggarwal, S, Behera, P
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.12.2013
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - injuries; Acetabulum - surgery; Acetabulum fracture; Adolescent; Adult; Female; Femur Head Necrosis - epidemiology; Fracture Fixation - methods; Fractures, Bone - classification; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Male; Middle Aged; Orthopedics; Osteoarthritis, Hip - epidemiology; Outcome; Postoperative Complications - epidemiology; Predictors; Prognosis; Radiography; Retrospective Studies; Sciatic Nerve - injuries; Surgery; Surgical treatment; Treatment Outcome; Young Adult; Prognosis; Surgical treatment; Outcome; Acetabulum fracture; Predictors
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2013.09.004

Summary Background The outcomes of surgically treated acetabular fractures are dependent on many factors. The purpose of this retrospective study is to evaluate these factors in a group of patients operated on by a single surgeon in one institute. Methods One hundred and eighteen patients, treated surgically for their displaced acetabular fracture and who had completed two years follow-up, were evaluated clinically with Modified Postel Merle d’Aubigné score and radiologically with Matta's radiological outcome grading. The effect of age (≤ 55 or >55 years), gender, fracture displacement (≤ 20 mm or >20 mm), hip dislocation, delay in surgery (≤ 2 weeks or >2 weeks), associated injury and length of follow-up (≤ 5 years or >5 years) on the functional outcome was evaluated. Results There were 99 (83.9%) males and 19 (16.1%) females with mean age of 38.75 years (16 to 65 years). The mean duration of follow-up was 3.95 years (range 2 to 14 years). The mean Modified Postel Merle d’Aubigné score was 15.7 ± 2.2 (range, 8 to 18). The clinical outcome was excellent in 27 (22.9%), good in 52 (44.2%), fair in 20 (16.9%), and poor in 19 (16.1%, 10 patients who underwent THR for secondary arthritis were considered as poor outcome) patients. The Modified Postel Merle d’Aubigné score was significantly affected by quality of reduction ( P = 0.0001), presence of associated injuries ( P = 0.0001), initial fracture displacement of >20 mm ( P = 0.018), joint dislocation ( P = 0.015) and delay in surgery ( P = 0.001). However, age, gender, fracture type and length of follow-up did not have any effects on the clinical outcome. Conclusion Poor reduction, associated injuries, fracture displacement of >20 mm, joint dislocation and late surgery definitely carry poor prognosis in predicting the outcome of surgically treated acetabular fractures. Level of evidence Level IV, retrospective study.