Outcomes after surgical treatment of acetabular fractures: a review

Ziran, Navid; Soles, Gillian; Matta, Joel M.

doi:10.1186/s13037-019-0196-2

Cited by 98 publications

(113 citation statements)

References 79 publications

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“…Two had inadequate reduction, that is, gap or step-off > 3mm according to Matta's criteria. Six of the eight cases achieved "satisfactory reduction", including the anatomical and the imperfect reduction [6,7]. The result regarding fracture reduction is comparable to the reported literatures [7].…”

Section: Preliminary Resultssupporting

confidence: 75%

“…Six of the eight cases achieved "satisfactory reduction", including the anatomical and the imperfect reduction [6,7]. The result regarding fracture reduction is comparable to the reported literatures [7]. Three of the eight patients were treated with anterior intrapelvic approach rst, which determined the major part of fracture reduction.…”

Section: Preliminary Resultssupporting

confidence: 67%

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Semiprone Position for Posterior Approaches to Acetabular fractures Allows Intuitive Radiographic Acquisition and Versatility for Surgical Hip Dislocation: A Technical Note and Preliminary Report

Lee

Chen

Tseng

et al. 2020

Preprint

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BackgroundAlthough the pros and cons of prone and decubitus positioning methods, for posterior approaches to acetabular fractures, have been widely discussed, it remains inconclusive whether a particular patient position is superior to the other. Here we present our preliminary experience with placing the patient in the semiprone position for posterior approaches to the acetabulum as a potentially advantageous alternative.MethodsTechnical notes were provided as well as the preoperative, intraoperative and postoperative images of the demonstrative cases. From July 2018 to April 2020, eight selected patients with complex acetabular fractures were surgically treated through posterior approaches in semiprone position. Patient demographics, fracture pattern, poor prognostic factors and associated conditions were recorded. The quality of fracture reduction was assessed by Modified Matta’s criteria. The operative hip’s function was evaluated by the Modified Merle d’Aubigné-Postel score if follow-up was more than 3 months.Result:The Median age of our cohort was 48.55 years (24.3–70.6). The median body mass index was 23.90 kg/ m2 (17.6–26.4). Satisfactory reduction was achieved in 6 of the 8 patients. Intraoperative radiographs obtained by the standard vertical and horizontal projection of the C-arm machine resembled the classic Judet views. Trochanteric flip osteotomy and surgical hip dislocation were feasible. One hip was converted to total hip replacement 5 months after primary fracture surgery due to femoral head osteonecrosis.Conclusion:The preliminary radiographic and reduction quality of our cohort were comparable to those reported in the literature. The advantages of semiprone position include intuitive intraoperative radiographic acquisition, making gravity as a aid for reduction and feasibility of surgical hip dislocation. Long-term follow-up and further case-controlled or randomized controlled studies are necessary to uphold its value.

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Section: Preliminary Resultssupporting

confidence: 75%

Section: Preliminary Resultssupporting

confidence: 67%

Semiprone Position for Posterior Approaches to Acetabular fractures Allows Intuitive Radiographic Acquisition and Versatility for Surgical Hip Dislocation: A Technical Note and Preliminary Report

Lee

Chen

Tseng

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Clinical outcomes were evaluated by Harris scores [12]. Pain was evaluated by the visual analog score (VAS score).…”

Section: Discussionmentioning

confidence: 99%

“…Pain was evaluated by the visual analog score (VAS score). Three kinds of complications were also recorded: heterotopic ossi cation (evaluated by Brooker grade [12]), posttraumatic arthritis (evaluated by Kellgren-Lawrence grade [12]) and avascular necrosis of the femoral head. These complications were commonly identi ed in our cases.…”

Section: Discussionmentioning

confidence: 99%

“…As we know, an isolated acetabular fracture might cause avascular necrosis of the femoral head, but the incidence rate is relatively low [29,37]. In a recent study [12], the incidence of avascular necrosis was 5.6% after traumatic acetabular fracture. When combined with proximal femoral fractures, the incidence rate of avascular necrosis might increase [13,38].…”

Section: Discussionmentioning

confidence: 99%

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Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

Liu

et al. 2020

Preprint

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Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.

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