Analysis of Predictors of Results after Surgical Treatment of Acetabular Fractures

Abstract

PurposeThe aim of this study was to analyze the factors affecting the outcomes after surgical treatment of acetabular fractures.Materials and MethodsBetween January 2000 and December 2012, 106 patients with acetabular fractures were treated with open reduction and internal fixation. We performed a retrospective cohort study to analyze the factors which may influence a patient's prognosis after surgical treatment of an acetabular fracture. The factors examined included age, femoral head injury, fracture type, dislocation, initial displacement, delay to injury-related surgery (in days), and quality of reduction. Additionally, we investigated clinical and radiological outcomes, as well as the development of osteoarthritis.ResultsPatients included 85 males (80.2%) and 21 females (18.8%) with a mean age of 50.4 (17-78) years. The mean follow-up period was 2.6 (1-10) years. In a univariable regression analysis, quality of reduction, age, and initial displacement were significantly associated with radiological and clinical outcomes. In a multivariable regression analysis, quality of reduction (P<0.001) and initial displacement (P=0.001) were found to be factors predictive of clinical and radiological outcomes. Additionally, the quality of reduction (P=0.005) was found to be predictive of osteoarthritis development.ConclusionStudy results indicated that the quality of reduction was the most important factor influencing the prognosis of patients with acetabular fractures.

Outcomes of Direct Infrapectineal Buttress Plate for Quadrilateral Surface Fractures of Acetabulum Using an Anterior Intrapelvic Approach

“…A road traffic accident was the predominant mode of injury in 15 patients. The most common fracture pattern was anterior column and posterior hemi-transverse in eight patients followed by true bicolumn 7) and T-type fractures 4) . Both transverse fractures were transtectal.…”

“…Displaced acetabular fractures frequently require open reduction and internal fixation (ORIF) to provide restoration of the congruent articular surface which is essential for optimal functional results 1 2 3 4) . Acetabular fractures with quadrilateral plate involvement typically involve comminution of fracture fragments, medial displacement of the femoral head, and impaction of the superior articular surface of the acetabulum.…”

“…Reduction and stable fixation of acetabular fractures is a challenging procedure 6) . Detailed preoperative planning and selection of an appropriate surgical approach are necessary to avoid complications and achieve optimal results 4 7) . The use of a standard ilio-inguinal approach, popularized by Letournel 8) , offers limited exposure and access to manipulate fragments of the quadrilateral plate.…”

Ilioinguinal Approach for Treatment of Acetabular Fractures

“…The displacement of the fracture reduction was 3 mm in 83% of these patients. Shin et al studied 106 patients with a follow-up period of 1-10 years and investigated the factors affecting the clinical and radiological results in surgical treatment of acetabular fractures (20). They reported that the most important factor affecting the radiographic and clinical results was the quality of fracture reduction.…”

Management of complex acetabulum fractures and their consequences

“…Наиболее часто встречающимся последствием переломов впадины является прогрессирующее развитие деформирующего артроза тазобедренного сустава (30%) [17]. На первый взгляд, очевидным является применение эндопротезирования как оптимального функционального метода восстановления поврежденного сустава [18].…”