Demographic Analysis of Acetabular Fractures Treated in a Quaternary Care Hospital From 2005 to 2016

Cavalcante, Marcelo Cortês; Arruda, Frederico Augusto Alves de; Boni, Guilherme; Sanchez, Gustavo Tadeu; Balbachevsky, Daniel; Reis, Fernando Baldy dos

doi:10.1590/1413-785220192706207042

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…Our higher observed rates could be as a result of a relatively prolonged duration of surgery. Our findings were similar to the 12.6 % infection rate noticed by Cavalcante [8] . We did not however, record any cases of thromboembolic disease, same as in the study by Khan et al [9] , or early post-operative mortality compared to the 4.3% mortality identified by Jindal and collaborators [21] following acetabular fracture surgery.…”

Section: Other Early Complicationssupporting

confidence: 92%

“…About 26% (15/57) of patients developed immediate or early post-operative complications. This was similar to the 22 % complication rate noticed by Cavalcante and colleagues [8] . The most significant early post-operative complications following the K-L approach are shown on table III.…”

Section: Immediate and Early Post-operative Complicationssupporting

confidence: 91%

“…A specific approach, the Kocher-Langenbeck's (K-L) approach has been described as the 'workhorse' for the reduction and fixation of acetabular fractures that require fixation via a posterior approach [6,7] . In the Calvacante et al demographic analysis of acetabular fractures treated surgically in Brazil in 2019 [8] , the Kocher-Langenbeck approach was used in over 62% fracture repair as the best approach and in about 7% of cases, it was combined with other approaches. This same approach was used in over 80% of Pakistani population in the study by Khan and collaborators in 2013 [9] , with results ranging from good to excellent.…”

Section: Introductionmentioning

confidence: 99%

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Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

2022

AJORR

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The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve retractors. Other early and late complications included surgical site infections (12.3%) and heterotopic ossification (8.8 %), respectively. The overall outcome following surgery by the K-L approach is satisfactory. However, there is need to ameliorate the technique, especially at the level of instrumentation, to limit post-operative complications.

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Section: Other Early Complicationssupporting

confidence: 92%

Section: Immediate and Early Post-operative Complicationssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

2022

AJORR

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“…2,20 In younger patients, posterior wall fracture was the most common fracture pattern seen, followed by transverse with posterior wall, and T-type fractures. 21,22 Ferguson et al 1 found that anterior column fracture, and anterior column with posterior hemitransverse fracture were more common among the geriatric patients as compared to the younger patients, and transverse with posterior wall fracture pattern was more common among the younger patients.…”

Section: Fracture Characteristicsmentioning

confidence: 99%

Acetabulum fractures in elderly: A systematic review of fracture pattern and treatment

Goyal

Singh

Trıpathy

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Acetabulum fractures are being increasingly seen with low impact injuries in elderly patients. This article aimed to study systematically literature on geriatric acetabulum fractures. Objectives of this systematic review were to study (1) demography of patients, common mechanisms of injury and types of fracture patterns commonly seen in elderly patients, (2) treatment used for these fractures in literature and (3) mortality rates in elderly with these fractures. Methods: Systematic search was carried out in May 2020 using predefined search strategy for all studies published in the English language in last 20 years. Literature search and data abstraction was done by two independent reviewers. Results: After screening of all abstracts, a total of 48 studies were included in the systematic review. In total there were 7876 geriatric patients with acetabulum fractures. Mean age of the patients was 72.47 years. There were 4841 males (61.5%). Fall from low heights was the most common mechanism of injury, present in 47.12% patients followed by motor vehicular accidents in 28.73%. Most common fracture pattern was both column fracture, seen in 19.03% patients, followed by anterior column and posterior hemitransverse fracture in 17.23%, anterior column fractures in 17.13%, and posterior wall fractures in 13.46% patients. Out of total 5160 patients for whom details of treatment were available, 2199 (42.62%) were given non-operative treatment, 2285 (44.28%) were treated with ORIF of acetabulum fracture, 161 (3.12%) were treated with percutaneous fixation and 515 (9.98%) were treated with primary THA. Gull sign, femoral head injury and posterior wall comminution were associated with poorer prognosis after ORIF and may form an indication for a primary THA. Conclusion: Literature on treatment of geriatric acetabulum fractures is not enough to draw any definite conclusions. There is limited evidence from current literature that surgery could be considered a safe treatment option for displaced acetabulum fractures in elderly. Primary THA can provide early mobility and reduce chances of resurgery in fracture patterns where restoration of joint surface may not be possible.

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“…Male to female ratio was 3.4:1 with male preponderance. Marcelo C C et al, 8 in 87 patients analysed 75 (77.3%) male and 10 females cases with fracture acetabulum. Boudissa M et al, 9 assessed 156 cases and had a majority of 126 (81%) male patients.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Socio-Demographic and Clinical Parameters after Open Reduction and Internal Fixation of Acetabulum Fractures

Kumar¹,

Sharma²,

Bhushan³

et al. 2022

IARJMS

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Background: The present study was done to evaluate the sociodemographic and clinical parameters after open reduction and internal fixation of acetabulum fractures. Material and methods: The present study was done in 44 patients of fracture acetabulum managed by open reduction internal fixation in the Department of Orthopaedic surgery, Indira Gandhi Medical College, Shimla. Results: There were 16 prospective (36.4%) and 28 retrospective (63.6%) cases. The mean age was 45.07 years with maximum number of 39 (88%) patients in the age group of 21- 60 years. Majority (77.3%) of the patients was males and 22.8 % were females. Forty three (97.7%) patients belonged to rural area and remaining 1(2.3%) patient belonged to urban area. Road traffic accident was the mode of injury in 63.6% patients followed by fall from height in 36.4%. Eighteen (41%) patients had posterior wall fracture followed by posterior wall with posterior column fracture was seen in 12 (27%). Average time interval between injury and surgery was 15 days (range 3-55 days). Thirty six percent of the patients were operated between 8-14 days and 34 % of patients between 0-7days. Thirty (68%) patients were operated by Kocher-Langenbeck approach in lateral position followed by 7 (15%) patients with ilioinguinal approach in supine position. Autogenous Bone graft was used in 31.7% of patients. Mean duration of hospital stay was 24 days (range 7-35 days). Conclusion: Study concluded that most of the patients were in the age group of 21- 60 years, males, belonged to rural area, injured due to Road traffic accidents, had posterior wall, operated within 15 days and were operated by Kocher-Langenbeck approach in lateral position.

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Demographic Analysis of Acetabular Fractures Treated in a Quaternary Care Hospital From 2005 to 2016

Cited by 7 publications

References 12 publications

Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

Acetabulum fractures in elderly: A systematic review of fracture pattern and treatment

Evaluation of Socio-Demographic and Clinical Parameters after Open Reduction and Internal Fixation of Acetabulum Fractures

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