Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

Seyed Amirreza Mesbahi, Ali Ghaemmaghami, Sara Ghaemmaghami, Pouya Farhadi

Abstract

Objective: To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures.

Methods: This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016. Functional and radiographic outcomes, and complication were considered as main outcomes.

Results: A total number of 79 patients completed the study. Fifty-five patients were operated through Kocher–Langenbeck approach, and 18 were operated through the standard ilioinguinal approach, and 6 patients were operated through the standard ilioinguinal approach combined with Kocher–Langenbeck approach. The mean follow-up of patients was 45.6 months. The average operative time was 162.4±78.5 min, and the median blood loss was 500 ml. Functional results were excellent in 41 patients (51.9%), good in 12 (15.2%), fair in 13 (16.5%), and poor in 13 patients (16.5%). Radiologic results were excellent in 27 cases (34.2%), good in 17 cases (21.5%), fair in 18 cases (22.8%), and poor in 16 (16.5%). Osteoarthritis of hip (60.8%) and AVN of head of femur (22.8%) were two most common complications. In addition, there wasn’t any significant difference between surgical approaches regarding clinical and radiographic outcomes.

Conclusion: The operative treatment for acetabular fractures gives universally satisfactory results. Thereafter, this study provides evidence that ilioinguinal approach is a good choice for anterior fractures, Kocher–Langenbeck is a good choice for posteriors fractures, and combined approach may be a good choice in the management of acetabular fractures involving two columns.

Keywords

Acetabular fracture; Internal fixation; Open reduction; Ilioinguinal approach; Kocher–Langenbeck approach

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