Effect of O-arm on reduction quality and functional recovery of acetabular dome impaction fractures: a retrospective clinical study

Abstract

Background Acetabular dome impaction fractures (ADIF) are difficult to reduce and have a high failure rate. the consistency between the acetabulum and femoral head is usually assessed under intraoperative X-ray fluoroscopy to evaluate the quality of fracture reduction.This study examines the effects of intraoperative mobile 2D/3DX imaging system (O-arm) on the reduction quality and functional recovery of Acetabular dome impaction fractures. Methods A retrospective analysis of the data of 48 patients with ADIF treated in Honghui Hospital from October 2018 to October 2021 was conducted.The patients were divided into the X-ray group and O-arm group. Residual step-off and gap displacements in the acetabular dome region were measured and the quality of fracture reduction was evaluated. Hip function was also evaluated according to the modified Merle d'Aubigné and Postel scoring system. Results There was no significant difference in preoperative general data between the two groups (P > 0.05).The residual average step displacement in the acetabular dome region was 3.48 ± 2.43mm and 1.61 ± 1.16mm(P < 0.05), and the gap displacement was 6.72 ± 3.69mm and 3.83 ± 1.67mm(P < 0.05) in the X-ray group and the O-arm group. In the X-ray group, according to the fracture reduction criteria described by Verbeek and Moed et al., 1 case was excellent, 13 cases were good, 11 cases were poor, and the rate of excellent and good was 56%; In the O-arm group, 7 cases were excellent, 12 cases were good, and 4 cases were poor, and the rate of excellent and good was 82.6% (P < 0.05). 46 patients gained follow-up, fracture healing, X-ray group at the last follow-up according to the modified Merled 'Aubigne&Postel function score: 3 cases were excellent,12 cases were good, 6 cases were middle, 3 cases were poor, the excellent and good rate of 62.5%, O-arm group: 15 cases were excellent,4 cases were good, 2 cases were middle, 1 cases were poor, the excellent and good rate was 86.4% (P < 0.05). Conclusions Application of O-arm in ADIF can have a positive impact on the improvement of fracture reduction quality and functional recovery.