A prospective study to analyse the surgical outcome of posterior acetabular fractures

Authors

  • Shaik Masthan Basha Department of Orthopaedics, ACSR Government Medical College and Hospital, Nellore, Andhra Pradesh, India
  • Vurundhur Divya Department of Orthopaedics, ACSR Government Medical College and Hospital, Nellore, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20194629

Keywords:

Acetabular fracture, Letournel-Judet classification, Kocher-Langenbeck approach, Harris hip score

Abstract

Background: Fractures of acetabulum are relatively uncommon, but because they involve major weight bearing joint in the lower extremity, they assume great clinical importance. Acetabular fractures are still difficult fractures to manage and are a major challenge to treating orthopaedic surgeon. The present study was aimed to study the surgical outcome of posterior acetabulum fractures and postoperative complications and failures.

Methods: A one year prospective study was done after ethical approval. Patients with traumatic injury and posterior acetabular fracture was included and categorized according to the Letournel-Judet classification. Kocher-Langenbeck approach was used for all the cases and clinical follow-up and radiological evaluation was done up to 12 months. Evaluation of different demographic elements with reference to Harris hip score was also carried out. Statistical analysis was performed using the Statistical Package for the Social Sciences software.

Results: Twenty cases with mean age 42.6 years and males 65% were included. Road traffic accident was cause in 65% of cases.50% of the cases had good, 20% excellent, 25% fair and 5% poor outcome in our study by Harris Hip scoring. Two cases of superficial infection, one deep infection, iatrogenic sciatic nerve injury in one, heterotopic ossification in one and one case of intra-articular screw penetration was observed.

Conclusions: Operative treatment of displaced acetabular fractures gives satisfactory functional results. Thorough evaluation of radiograph/ CT scan and a proper pre-operative planning is necessary for decision making regarding an appropriate surgical approach, the appropriate type of implant and fixation.

Author Biographies

Shaik Masthan Basha, Department of Orthopaedics, ACSR Government Medical College and Hospital, Nellore, Andhra Pradesh, India

ASSISTANT PROFESSOR, DEPARTMENT OF ORTHOPAEDICS

Vurundhur Divya, Department of Orthopaedics, ACSR Government Medical College and Hospital, Nellore, Andhra Pradesh, India

ASSISTANT PROFESSOR, DEPARTMENT OF ORTHOPAEDICS

References

Pantazopoulos T, Mousafiris C. Surgical treatment of central acetabular fractures. Clin Orthop Relat Res. 1989;246:57-64.

Gänsslen A, Pohlemann T, Krettek C. Der einfache supraazetabuläre Fixateur externe für die Behandlung von Beckenfrakturen. Operative Orthopädie und Traumatologie. 2005;17(3):296-312.

Alton TB, Gee AO. Classifications in brief: Letournel classification for acetabular fractures. Clin Orthop Related Res. 2014;1(472):35-8.

Briffa N, Pearce R, Hill AM, Bircher M. Outcomes of acetabular fracture fixation with ten years' follow-up. J Bone Joint Surg Br. 2011;93(2):229- 36.

Heeg M, Klasen HJ, Visser JD. Operative treatment for acetabular fractures. J Bone Joint Surg Br. 1990;72(3):383-6.

Sahin V, Karakaş ES, Aksu S, Atlihan D, Turk CY, Halici M. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma. 2003;54:520-9.

Amaravati RS, Phaneesha MS, Rajagopal HP, Reddy R. Treatment of acetabular fractures. Indian J Orthop. 2005;39:26-9.

Dakin GJ, Eberhardt AW, Alonso JE, Stannard JP, Mann KA. Acetabular fracture patterns: association with motor vehicle crash information. J Trauma. 1999;47:1063-71.

Alonso JE, Volgas DA, Giordano V, Stannard JP. A review of treatment of Hip dislocation associated with acetabular fractures. Clin Orthop. 2000;377:32-43.

Pape HC, Rice J, Wolfram K, Gänsslen A, Pohlemann T, Krettek C. Hip dislocation in patients with multiple injuries: a followup investigation. Clin Orthop. 2000;377:99-105.

Lim HH, Tang CL, Krishnamoorthy S. Operative treatment of acetabular fractures. Singapore Med J. 1994;35(2):173-6.

Fica G, Cordova M, Guzman L, Schweitzer D. Open reduction and internal fixation of acetabular fractures. Int Orthop. 1999;22(6):348-51.

Giannoudis PV, Grotz MR, Papakostidis C, Dinopoulos H. Operative treatment of displaced fractures of the acetabulum.A meta-analysis. J Bone Joint Surg Br. 2005;87(1):2-9.

Anizar-Faizi A, Hisam A, Sudhagar KP, Moganadass M, Suresh C. Outcome of surgical treatment for displaced acetabularfractures. Malays Orthop J. 2014;8(3):1-6.

Ovre S, Sandvik L, Madsen JE, Roise O. Modification of the Harris Hip Score in acetabular fracture treatment. Injury. 2007;38:344-9.

Giordano V, Amaral NPD, Franklin CE, Pallottino A, Albuquerque RP. Functional outcome after operative treatment of displaced fractures of the acetabulum. Eur J Trauma Emerg Surg. 2007;33:520-7.

Etemadifar M, Nemati A, Chinigarzade M. Operative management of acetabular fracture: a 10-year experience in Isfahan Iran. Adv Biomed Res. 2016;5:169.

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Published

2019-10-22

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Original Research Articles