Comparison of Outcomes and Complications of Isolated Acetabular Fractures and Acetabular Fractures With Associated Injuries

Phruetthiphat, Ong-art; Willey, Michael; Karam, Matthew D.; Gao, Yubo; Westerlind, Brian O.; Marsh, J. Lawrence

doi:10.1097/bot.0000000000000720

Cited by 23 publications

(18 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among these, 158 papers were finally considered for eligibility and 80 papers were finally included in the review. In severe pelvic injuries, there is an 80% chance of associated other intrapelvic lesions, 4,5 , thoracoabdominal injuries like ribs or stern fractures, pneumothorax, liver laceration, and splenic rupture, small or large intestine lesions, 6,7 and other local lesion involving soft tissues (over 72% of patients), rectum and sphincters (18 -64%), urethra (1,6 -25 %), bladder (neurogenic bladder, structural rupture), vagina, nerves, 8 as well as post-traumatic osteoarthritis (7 -40%) 9 , heterotopic ossification, 10,11 and ischemic necrosis of the femoral head. 9 Pelvic ring and acetabular fractures often present with perineal swelling of soft tissue, due to the hemorrhage that develops into the retroperitoneal space and flows dissecting fascial planes into the scrotum.…”

Section: Resultsmentioning

confidence: 99%

“…22 In a study on unstable PF, after surgical treatment, the healing time for PF was between 12 and 18 weeks, while for acetabular fractures it was between 12 and 22 weeks. 6 A previous systematic review of multidisciplinary rehabilitative interventions in patients with multiple trauma 24 and a recent paper highlighted the lack of guidelines for post-surgical rehabilitation in PF. 25 Early rehabilitation of the patient with PF may begin with prevention strategies, principally of skin ulcers, loss of Range of Movement (ROM), joint contractures and urogenital disorders.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Rehabilitative management of pelvic fractures: a literature-based update

et al. 2021

View full text Add to dashboard Cite

A comprehensive rehabilitation program is required after Pelvic Fracture (PF). In a PF rehabilitation setting an effective treatment and a proper management of complications is supplied by an appropriate and reliable clinical assessment. In this literature-based update, we search on MEDLINE, EMBASE, and the Cochrane Database of Systematic reviews to find articles, scientific society guidelines and practioners experiences defining the rehabilitative management of clinically PF outcomes. Based on literature evidences and expert opinions, a set of key topics was collated to generate advices and recommendations to put into daily practice. Even if there are no high-quality evidence for rehabilitative interventions after PF in terms of duration and modality of therapy, rehabilitation setting, care pathways, and long-term functional outcomes, it is strongly recommended an early multidisciplinary intervention to improve recovery from PF.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Rehabilitative management of pelvic fractures: a literature-based update

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Since the incidence of isolated acetabular fractures after a fall on their side is significantly higher among elderly people than in other age groups and the concomitant nonacetabular injuries are mostly resulted from a high-energy trauma [ 36 ], only the impact-side hemipelvis was studied here. Also, to increase the accuracy at the region of interest and reduce overall computational costs, only the bony parts at the impact-side hemipelvis meshed with quadratic 10-node tetrahedral solid elements, and the other parts meshed with linear 4-node tetrahedral solid elements [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of osteoporosis-related reduction in the mechanical properties of bone on the acetabular fracture during a sideways fall: A parametric finite element approach

et al. 2022

View full text Add to dashboard Cite

Purpose The incidence of acetabular fractures due to low-energy falls is increasing among the geriatric population. Studies have shown that several biomechanical factors such as body configuration, impact velocity, and trochanteric soft-tissue thickness contribute to the severity and type of acetabular fracture. The effect of reduction in apparent density and elastic modulus of bone as well as other bone mechanical properties due to osteoporosis on low-energy acetabular fractures has not been investigated. Methods The current comprehensive finite element study aimed to study the effect of reduction in bone mechanical properties (trabecular, cortical, and trabecular + cortical) on the risk and type of acetabular fracture. Also, the effect of reduction in the mechanical properties of bone on the load-transferring mechanism within the pelvic girdle was examined. Results We observed that while the reduction in the mechanical properties of trabecular bone considerably affects the severity and area of trabecular bone failure, reduction in mechanical properties of cortical bone moderately influences both cortical and trabecular bone failure. The results also indicated that by reducing bone mechanical properties, the type of acetabular fracture turns from elementary to associated, which requires a more extensive intervention and rehabilitation period. Finally, we observed that the cortical bone plays a substantial role in load transfer, and by increasing reduction in the mechanical properties of cortical bone, a greater share of load is transmitted toward the pubic symphysis. Conclusion This study increases our understanding of the effect of osteoporosis progression on the incidence of low-energy acetabular fractures. The osteoporosis-related reduction in the mechanical properties of cortical bone appears to affect both the cortical and trabecular bones. Also, during the extreme reduction in the mechanical properties of bone, the acetabular fracture type will be more complicated. Finally, during the final stages of osteoporosis (high reduction in mechanical properties of bone) a smaller share of impact load is transferred by impact-side hemipelvis to the sacrum, therefore, an osteoporotic pelvis might mitigate the risk of sacral fracture.

show abstract

“…In patients with combined pelvic fracture and spine injury, treatment of the pelvic fracture is often delayed until the life-threatening spine injury has been dealt with, but whether this results in worse postoperative outcome of the pelvic fracture is not known [ 33 , 41 , 42 ]. The aim of this multicenter cohort study was to investigate how the postoperative outcome, follow-up and surgical treatment are influenced with a concomitant spine injury.…”

Section: Introductionmentioning

confidence: 99%

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Navas

Mengis

Zimmerer

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Pelvic fractures are often associated with spine injury in polytrauma patients. This study aimed to determine whether concomitant spine injury influence the surgical outcome of pelvic fracture. Methods We performed a retrospective analysis of data of patients registered in the German Pelvic Registry between January 2003 and December 2017. Clinical characteristics, surgical parameters, and outcomes were compared between patients with isolated pelvic fracture (group A) and patients with pelvic fracture plus spine injury (group B). We also compared apart patients with isolated acetabular fracture (group C) versus patients with acetabular fracture plus spine injury (group D). Results Surgery for pelvic fracture was significantly more common in group B than in group A (38.3% vs. 36.6%; p = 0.0002), as also emergency pelvic stabilizations (9.5% vs. 6.7%; p < 0.0001). The mean time to emergency stabilization was longer in group B (137 ± 106 min vs. 113 ± 97 min; p < 0.0001), as well as the mean time until definitive stabilization of the pelvic fracture (7.3 ± 4 days vs. 5.4 ± 8.0 days; p = 0.147). The mean duration of treatment and the morbidity and mortality rates were all significantly higher in group B (p < 0.0001). Operation time was significantly shorter in group C than in group D (176 ± 81 min vs. 203 ± 119 min, p < 0.0001). Intraoperative blood loss was not significantly different between the two groups with acetabular injuries. Although preoperative acetabular fracture dislocation was slightly less common in group D, postoperative fracture dislocation was slightly more common. The distribution of Matta grades was significantly different between the two groups. Patients with isolated acetabular injuries were significantly less likely to have neurological deficit at discharge (94.5%; p < 0.0001). In-hospital complications were more common in patients with combined spine plus pelvic injuries (groups B and D) than in patients with isolated pelvic and acetabular injury (groups A and C). Conclusions Delaying definitive surgical treatment of pelvic fractures due to spinal cord injury appears to have a negative impact on the outcome of pelvic fractures, especially on the quality of reduction of acetabular fractures.

show abstract

Comparison of Outcomes and Complications of Isolated Acetabular Fractures and Acetabular Fractures With Associated Injuries

Abstract: Prognostic level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 23 publications

References 18 publications

Rehabilitative management of pelvic fractures: a literature-based update

Rehabilitative management of pelvic fractures: a literature-based update

Effect of osteoporosis-related reduction in the mechanical properties of bone on the acetabular fracture during a sideways fall: A parametric finite element approach

Patients with combined pelvic and spinal injuries have worse clinical and operative outcomes than patients with isolated pelvic injuries analysis of the German Pelvic Registry

Contact Info

Product

Resources

About