Published: 2016-12-29

Acetabular fractures: an analysis on clinical outcomes of surgical treatment

Meenakshi Sundaram Kandasamy, Manivelavan Duraisamy, Kandasamy Ganeshsankar, Vijayan Gopala Krishnan Kurup, Shankar Radhakrishnan


Background: Acetabulum fractures are among the most serious injuries treated by orthopedic surgeons. People of all ages are vulnerable to these injuries. ORIF is considered the right treatment method for acetabular fractures. Patients who underwent this treatment had a good result. For the general orthopedic surgeon the treatment for displaced acetabular fracture is a challenging task. The aim of the study was to evaluate the functional outcome of surgically treated acetabular fractures.

Methods: A prospective longitudinal study was undertaken in our hospital during the period of June 2011–June 2015. A total number of 32 patients were included in the study. All patients with the history of fall and pain in the pelvic region were examined clinically and radiologically by doing an X-ray of plain AP view of the pelvis as well as CT-scan. Fractures that were displaced by more than 5 mm with concomitant disruption of the bony continuity of the acetabular dome were treated surgically. The follow-up schedule was 3, 6 and 12 months post-operatively and subsequently at two years when the operative outcome had been finalized and final evaluation of fracture healing and functional outcome was performed.

Results: Radiologic evaluation showed 88.5% of excellent or good results and 12.5% of fair or poor results, while clinical evaluation showed 90.6% of excellent or good results and 9.4% of fair or poor results. The clinical evaluation was done for the patients based on the D’Aubigne-Postel criterion. . Based on this criterion 90% of the patients had shown good to excellent results and for the remaining 10% of the patients it was between poor and fair.

Conclusions: In acetabular fractures open reduction and internal fixation was consistent with better anatomical reduction and functional outcome provided when it is carried out by an experienced surgeon and intervened within the first few days following the injury. 


Acetabular fracture, Open reduction, Internal fixation, Radiological and clinical evaluation

Full Text:



Eliezer EN, Haonga B, Mrita FS, Liu MB, Wu H. Functional outcome and Quality of Life after Surgical Management of Displaced Acetabular Fractures in Tanzania. East African Orthopaed J. 2016;10:16-20.

Bhat NA, Kangoo KA, Wanil IH, Wali GR, Muzaffar N, Dar RA. Operative Management of Displaced Acetabular Fractures: an Institutional Experience with a Midterm Follow-up. Orthopedia Traumatologia Rehabilitacja. 2014;3(6):245-52.

Khan SH, Ara I, Raza S, Sipra S. Functional outcome of Surgery in Patients with Acetabular Fractures. J Ayub Med Coll Abbottabad. 2013;25(1-2):60-3.

Rahimi H, Gharahdaghi M, Parsa A, Assadian M. Surgical Management of Acetabular Fractures: A Case Series. Trauma Mon. 2013;18(1):28-31.

Judet R, Judet J, Letournel E. Fractures of the Acetabulum. Acta Orthop Belg. 1964;30:285-93.

Kumar A, Shah NA, Kershaw SA, Clayson AD. Operative management of acetabular fractures. A review of 73 fractures. Injury. 2005;36(5):605-12.

Gupta RK, Singh H, Dev B, Kansay R, Gupta P, Garg S. Results of operative treatment of acetabular fractures from the Third World–how local factors affect the outcome. Int Orthop. 2009;33(2):347-52.

Judet T, Judet J, Letournel E. Fractures of the Acetabulum: Classification and surgical approaches for open reduction. J Bone Joint Surg. 1964;46:1615.

Letournel E. Acetabular Fractures. Classification and Management. Clin Orthop. 1980;151:81.

Matta MJ, Anderson ML, Epsein CH, Hendrics P. Fractures of the Acetabulum. Clin Orthop Rel Res. 1986;205:230-40.

Moroni A, Caja LV, Sabato C, Zinghi G. Surgical treatment of both - column fractures by staged combined ilioinguinal and Kocher -Langenbeck approaches. Injury. 1995;26(4):219-24.

Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1993:78:1632–45.

Βosse JM, Reinert M, Ellwanger F, Slawson R, Mc Devitt. Heterotopic Ossification as a Coplication of Acetabular Fracture. J Bone and Joint Surg. 1988;70(8):1231-7.

Bray JT, Esser M, Fulkerson L. Osteotomy of the Trochader in Open Reduction and Internal Fixation of Acetabular Fractures. J Bone Joint Surg. 1987;69(5):711-7.

Chip Routt LM, Swiontkowski FM. Operative Treatment of Complex Acetabular Fractures. J Bone Joint Surg. 1990;72(6):897-904.

Gansslen A, Steinke B, Krettek C. Internal fixation of acetabular posterior wall fractures. Oper Orthop Traumatol. 2009;21(3):283-95.

Kumar A, Shah NA, Kershaw SA, Clayson AD. Operative management of acetabular fracture: a review of 73 fractures. Injury. 2005;36(5):605-12.

Pavelka T, Houcek P. Complications associated with the surgical treatment of acetabular fracture. Acta Chir Orthop Traumatol Cech. 2009;76(3):186-93.

El-khadrawe TA, Hammad AS, Hassaan AE. Indicators of outcome after internal fixation of complex acetabular fractures. Alex J Med. 2012;48:99-107.