Epidemiological assessment of acetabular fractures in a level one trauma centre: A 7-Year observational study

Trikha, Vivek; Ganesh,; Cabrera, David Alejandro; Bansal, Hemant; Mittal, Samarth; Vp, Sharma

doi:10.1016/j.jcot.2020.09.009

Cited by 11 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, lower limb fractures were observed in 32% of pelvic ring fractures and 36% of acetabular fractures. This is comparable with epidemiological analysis in India demonstrating lower limb fractures in 29% of pelvic ring fractures and 26% of acetabular fractures[ 6 , 16 ]. When comparing pelvic ring and acetabular fractures, there was a significant association between pelvic ring fractures and both spine fractures ( P < 0.001) and abdominal injury ( P = 0.01).…”

Section: Discussionsupporting

confidence: 88%

Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

Cuthbert¹,

Walters²,

Ferguson³

et al. 2022

WJO

View full text Add to dashboard Cite

BACKGROUND Despite motor-vehicle safety advancements and increasingly rigorous workplace safety regulations, trauma/suicide remains the leading cause of death under the age of 45 in the United Kingdom. To promote centralisation of care and optimisation of major trauma outcomes, in 2012 the National Health Service introduced the Trauma Network System. To our knowledge, this is the first study to analyse the epidemiology of pelvic and acetabular trauma over a one-year period at a level-1 trauma centre in the United Kingdom, since nationwide introduction of the Trauma Network System. AIM To characterize the epidemiology of high-energy pelvic and acetabular fractures over a one-year period at a level-1 trauma centre, and explore both resources required to care for these patients and opportunities for future research and injury prevention initiatives. METHODS 227 consecutive patients at a level-1 trauma centre with pelvic and acetabular fractures were analysed between December 2017-December 2018. Paediatric patients (< 18 years) and fragility fractures were excluded, leaving 175 patients for inclusion in the study. Statistical analysis was performed using Fisher’s exact test for categorical variables. RESULTS 72% of pelvic and acetabular fractures occurred in male patients at a median age of 45 years. 15% were the result of a suicide attempt. 48% of patients required pelvic or acetabular surgery, with 38% undergoing further surgery for additional orthopaedic injuries. 43% of patients were admitted to intensive care. The median inpatient stay was 13 days, and the 30- day mortality was 5%. Pelvic ring trauma was more commonly associated with abdominal injury ( P = 0.01) and spine fractures ( P < 0.001) than acetabular fractures. Vertical shear pelvic ring fractures were associated with falls ( P = 0.03) while lateral compression fractures were associated with road traffic accidents ( P = 0.01). CONCLUSION High energy pelvic and acetabular fractures are associated with concomitant orthopaedic fractures (most commonly spine and lower limb), intensive care admission and prolonged inpatient stays. Most pelvic ring injuries secondary to road traffic accidents are lateral compression type, demonstrating the need for future research to drive advancements in lateral impact vehicle safety along with mental health surveillance for those deemed to be potential suicide risks.

show abstract

Section: Discussionsupporting

confidence: 88%

Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

Cuthbert¹,

Walters²,

Ferguson³

et al. 2022

WJO

View full text Add to dashboard Cite

show abstract

“…With an enlarging population of older people, the former group now represents the bigger subset of patients who present with factors associated with unfavourable outcomes [18]. Patients over the age of 60 years historically comprised about 11-18% of all acetabular fractures [21,29,30] and more recent articles report a strong increase in incidence among elderly subjects sustaining such injuries of up to 64% [31][32][33]. When treated with ORIF, the proportion requiring THA for post-traumatic arthritis can range 22-64% at 3 years [2][3][4][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Acute versus delayed total hip arthroplasty after acetabular fracture fixation: a systematic review and meta-analysis

Liang

Gani

Culpan

et al. 2023

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Background Post-traumatic osteoarthritis (PTOA) is a disabling complication of open reduction and internal fixation (ORIF) for acetabular fractures. There is a trend towards acute total hip arthroplasty (THA), ‘fix-and-replace’, in patients considered to have a poor prognosis and likelihood of PTOA. Controversy remains between early fix-and-replace, versus delayed THA as required after initial ORIF. This systematic review included studies comparing functional and clinical outcomes between acute versus delayed THA after displaced acetabular fractures. Methods Comprehensive searches following the PRISMA guideline were performed on six databases for articles in English published anytime up to 29 March 2021. Two authors screened articles and discrepancies were resolved by consensus. Patient demographics, fracture classification, functional and clinical outcomes were compiled and analysed. Results The search yielded 2770 unique studies, of which five retrospective studies were identified with a total of 255 patients. Of them, 138 (54.1%) were treated with acute and 117 (45.9%) treated with delayed THA. Delayed THA group represented a younger cohort compared to the acute group (mean age, 64.3 vs 73.3). The mean follow-up time for the acute and delayed group was 23 and 50 months, respectively. There was no difference in functional outcomes between the two study groups. Complication and mortality rates were comparable. Delayed THA had a higher revision rate compared to the acute group (17.1 vs 4.3%; p = 0.002). Conclusion Fix-and-replace had functional outcomes and complication rates similar to ORIF and delayed THA, but lower revision rates. Although the quality of studies was mixed, sufficient equipoise now exists to justify randomised studies in this area. PROSPERO registration: CRD42021235730

show abstract

“…Trikha et al and Fakru et al reported the posterior wall fracture as the most common type of acetabular fracture, whereas in our studied population, the dominant injury was anterior column fracture. This nding is particularly intriguing considering that all three studies identi ed tra c accidents as the main cause of acetabular fractures [28,29]. Providing a satisfactory explanation for these discrepancies seems challenging at this point.…”

Section: Discussionmentioning

confidence: 99%

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

Wójcicki,

Pielak,

Walus

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: The objective of this retrospective study was to investigate the association between acetabulum fractures, mechanism of injury, and variables such as BMI, duration of hospital stay, blood loss, and surgery time. By exploring these factors, we aim to enhance our understanding of the accompanying factors of pelvic fractures and their impact on the healing process and subsequent management. Methods: This study included 136 consecutive patients who were admitted for pelvic ring fracture surgery between 2017 and 2022. The data was collected prospectively at a single trauma center. . The inclusion criteria were acetabulum fractures and indications for operative treatment. The exclusion criteria were non-operative treatment for acetabular and pelvic ring fractures, fractures requiring primary total hip arthroplasty (THA), and periprosthetic acetabular fractures. Upon admission, all patients underwent evaluation using X-ray and computed tomography (CT) scans of the pelvis. Results: The present study found no statistically significant differences among the examined groups of patients with pelvic fractures in terms of BMI, surgery duration, length of hospital stay, and blood transfusion. However, two notable findings approached statistical significance. Firstly, patients who experienced a fall from height while sustaining a pelvic fracture required a higher number of blood transfusions (2.3 units) compared to other mechanisms of injury (Fig. 2D), which was close to achieving statistical significance (p=0.07). Secondly, patients undergoing posterior wall stabilization exhibited a significantly lower number of blood transfusions compared to other specific pelvic injuries (0.33 units per patient), approaching statistical significance (p=0.056). Conlusions: We firmly believe that our study has provided valuable insights into pelvic fractures and their association with the investigated factors. The findings indicate that factors such as BMI, time of surgery, blood loss, and duration of hospital stay are not directly correlated with the morphology of acetabular fractures, the presence of additional trauma, or the mechanism of injury. However, it is worth noting that many of our findings align with existing literature on the subject.

show abstract

Epidemiological assessment of acetabular fractures in a level one trauma centre: A 7-Year observational study

Cited by 11 publications

References 29 publications

Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

Acute versus delayed total hip arthroplasty after acetabular fracture fixation: a systematic review and meta-analysis

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

Contact Info

Product

Resources

About