Acetabular fractures: short-term results

• Published in: Revista española de cirugía ortopédica y traumatología Vol. 56; no. 1; pp. 17 - 23
• Main Authors: Estrems-Díaz, V, Hernández-Ferrando, L, Balaguer-Andrés, J, Bru-Pomer, A
• Format: Journal Article
• Language: Spanish
• Published: 01.01.2012
• ISSN: 1988-8856
• DOI: 10.1016/j.recot.2011.09.001

OBJECTIVETo evaluate the results of surgical treatment of displaced acetabular fractures, and to discern which variables influence the final radiological and clinical outcome.METHODSWe retrospectively analyzed 23 patients who underwent open reduction and internal fixation of acetabular fracture with a mean age of 40.4 years (17-72 years). Mean follow-up was 4 years (1.5-7.5 years). According to Judet and Letournel classification, we operated 10 simple fractures (43.5%) and 13 complex (56.5%), with both-column fractures being the most common type (8 hips). We evaluated the quality of reduction achieved, the clinical results and the occurrence of coxarthrosis.RESULTSWe obtained anatomic reduction of the lesion in 12 cases (52%), in 7 (30%) residual displacement was less than 2mm, and in 4 patients (17%) greater than 2mm. According to Harris' score, the clinical outcome was excellent or good in 18 cases (78%) and fair or poor in 5 (22%), getting worse in complex fractures and when we do not reach an anatomic reduction of the injury. Six patients (26%) developed moderate or severe degenerative changes during follow-up. The degree of postoperative reduction obtained was identified as the main predictor of the development of post-traumatic osteoarthritis.DISCUSSION AND CONCLUSIONSThe acquisition by open reduction and internal fixation of an accurate congruence between the femoral head and acetabulum is essential to achieve good long-term results.