Operative Management of Displaced Acetabular Fractures: an Institutional Experience with a Midterm Follow-up

Bhat, Nawaz A.; Kangoo, Khurshid Ahmad; Wani, Iftikhar H; Wali, Gowher; Muzaffar, Nasir; Dar, Reyaz Ahmad

doi:10.5604/15093492.1112281

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…It is essential to achieve anatomical reduction and hip joint congruency, including secondary surgical congruency, of both-column acetabular fractures for rapid postoperative recovery and early rehabilitation as well as maintaining longterm hip joint function. [1][2][3][4][5][6][7] The treatment of both-column acetabular fractures is technically challenging owing to the complex regional anatomy of the pelvis and the complicated fracture configurations. Moreover, these injuries are located deep within the pelvis and are anatomically surrounded by major organs and neurovascular structures; thus, securing an adequate surgical field of view is generally difficult.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Printing-Assisted Surgical Technique with Limited Exposure for Both-Column Acetabular Fractures

Shon¹,

Choi

Yang³

2018

Ulus Travma Acil Cerrahi Derg

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Section: Introductionmentioning

confidence: 99%

Three-Dimensional Printing-Assisted Surgical Technique with Limited Exposure for Both-Column Acetabular Fractures

Shon¹,

Choi

Yang³

2018

Ulus Travma Acil Cerrahi Derg

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“…Our study, however, did not find such a direct relationship. Still, some authors point out [2,35] that proper reconstruction of joint surfaces is more difficult to achieve in more complex injuries, and this may diminish patients' functional state. Even though our patients had poor mean functional abilities (Table 2), we found that patients who had poorer quality of fixation scored even fewer points in functional scales (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Radiological and Functional Assessment of Treatment Outcomes in Patients after Open Reduction with Internal Fixation (ORIF) of Acetabular Fractures

Dadura

Truszczyńska-Baszak

Szydłowski

2022

IJERPH

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(1) Fracture of the pelvis usually happens in young men and results from high-energy trauma. It generates high social and economic costs and results in further health problems. It is therefore important to assess long-term treatment results. (2) The study (NCT04902209) involved 31 patients (mean age 43.6 ± 14.8 years). We conducted fixation assessment on the basis of radiographs and CT scans and functional assessment based on functional scales. (3) We observed more degenerative changes in the less precise reconstruction of the acetabulum (p = 0.075). We did not find statistically significant relationships between the area of surgical approach, the gravity of fracture, and the development of degenerative changes. We did not find statistically significant relationships between patients’ functional states and the type of surgical approach or the complexity of the fracture. We found a positive correlation between the time of surgical treatment and patients’ functional state (p = 0.04). Patients whose joint surfaces were reconstructed anatomically had significantly higher scores in functional scales (HHS p = 0.05, Merle p = 0.03). (4) Patients after surgical fixation of the acetabulum have low functional abilities. The quality of reconstruction of the loaded surface as well as the length of time post-surgery seems to be essential for the patients’ functional state.

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“…In previously reported studies, both radiological and functional outcomes and complication rates differ depending on the intervention performed during acetabular surgery ( Table 5 ) [ 5 , 7 , 9 – 11 , 16 , 20 – 23 , 25 – 35 ]. Surgical experience leads to lower complication rates and a higher chance of excellent reduction [ 10 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…All patients were treated postoperatively for 48 hours with prophylactic antibiotics with a first-generation cephalosporin, and for ten days with anticoagulant prophylaxis with low molecular weight (LMWH). Oral indomethacin treatment was given for three months to all patients operated through the posterior and combined approach, as prophylaxis for heterotopic ossification (HO) [ 16 ]. Isometric exercises, including ankle pumps, static quadriceps, and gluteal exercises were begun on day one after surgery.…”

Section: Methodsmentioning

confidence: 99%

Learning Curve for Surgical Treatment of Acetabular Fractures: A Retrospective Clinical Study of a Practical and Theoretical Training Course

et al. 2017

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BackgroundSurgical treatment of acetabular fracture and the anatomic reconstruction of the hip joint are difficult to achieve due to the complex pelvic anatomy, and surgical training requires a prolonged and steep learning curve. The aim of this study was to evaluate the effects of an applied training course, including cadaveric dissection, for the surgical treatment of acetabular fractures.Material/MethodsThis retrospective study included 35 patients who underwent surgical treatment for acetabulum fractures between 2012–2016. Patients were divided into three groups during two training courses, for the first two years and second two years. The surgical treatment was performed through single or combined standard approaches, according to the fracture pattern. The radiological outcome was evaluated using Matta’s criteria to grade postoperative reduction and final radiological outcome and the restoration of the hip joint center (HJC). The clinical outcome was evaluated using the modified the Merle d’Aubigné-Postel (DAP) hip score.ResultsBoth post-course groups had statistically better functional and radiological outcomes compared with the pre-course group. Depending on the learning curve, the mean duration of surgery decreased from 153 minutes to 82.3 minutes. Although there was no statistical difference between groups in the vertical shift of the HJC, there was a statistically significant in the amount of horizontal shift of the HJC in the second two years of training, compared with the other groups.ConclusionsFunctional and radiological outcome of surgical treatment of acetabular fracture may be improved with increased training, depending on the learning curve.

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Operative Management of Displaced Acetabular Fractures: an Institutional Experience with a Midterm Follow-up

Cited by 8 publications

References 23 publications

Three-Dimensional Printing-Assisted Surgical Technique with Limited Exposure for Both-Column Acetabular Fractures

Three-Dimensional Printing-Assisted Surgical Technique with Limited Exposure for Both-Column Acetabular Fractures

Radiological and Functional Assessment of Treatment Outcomes in Patients after Open Reduction with Internal Fixation (ORIF) of Acetabular Fractures

Learning Curve for Surgical Treatment of Acetabular Fractures: A Retrospective Clinical Study of a Practical and Theoretical Training Course

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