Acetabular fractures with marginal impaction

Abstract

Purpose: clinical and radiological evaluation of the results of the technique of elevation and grafting of osteochondral marginal impaction fragment of posterior wall acetabular fractures and complications assessment in follow up period 1-3 years. Methods: Twenty patients were available for this study had fracture acetabulum with marginal impaction fragment. Elevation, reduction and bone graft impaction of the defect was the technique in all cases. Follow up was 1-3 years. Evaluation of patient was done clinically and radiologically. Results: Radiologically, according to the Matta's criteria of reduction quality there were anatomic reduction in 16 patients (80%), and satisfactory reduction in 4 patients(20%). Clinical assessments based on modified Merle d' Aubigné and Postel score include 4 (20%) excellent scores and 12 (80%) good scores, and 3 (15%) fair results, and poor in one patient who had revision by total hip replacement. Conclusion: Diagnose of marginal impaction fragment preoperatively makes operative technique by elevation, reduction, bone graft packing, and fixation become mandatory to obtain anatomic reduction and favorable outcome. This technique should be completed before final fixation of the main fracture acetabulum.

Impact of Computed Tomography on Operative Planning for Ankle Fractures Involving the Posterior Malleolus

“…This term was first used in reference to posterior wall fractures of the acetabulum. It is described as “a rotated, impacted single or multi-fragmented fracture with depression of the osteochondral fragments into the underlying cancellous bone.” 11,21 Mc Connell and Tornetta adapted this to describe plafond impaction in Supination-Adduction type fractures of the ankle, but it has never been described in direct association with posterior malleolus fractures. 25 There is limited data on the best modality to identify marginal impaction, but computed tomography (CT) scans are commonly used.…”

Acetabular fractures in skeletally immature rugby players

“…Marginal impaction of the acetabulum, occurring as a result of force transmission through the femoral head is a poor prognostic marker associated with posterior wall fractures. Following operative fixation, 25% of patients with this specific fracture pattern, have a poor mid-term result 11. There was evidence of marginal impaction in two of the four fractures in this series.…”

Tratamiento quirúrgico de las fractura de pared posterior de acetábulo. Resultados a corto y mediano plazo

“…La impactación marginal se reporta en alrededor del 30% de los pacientes. 17,18 Para el tratamiento de esa lesión en particular se plantea rellenar la cavidad con el fin de recuperar la relación de la cabeza femoral dentro del acetábulo. Para ello, se debe primero identificar la impactación, luego levantar el fragmento y rotarlo a su posición natural.…”