Surgical and functional outcome of management of anterior column with posterior hemitransverse fracture of acetabulum
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20241705Keywords:
Acetabular fracture, Anterior column with posterior hemitransverse fracture, Ilioinguinal approach, Modified Stoppa approach, Modified Merle d’Aubigne, Postel scoreAbstract
Fractures of acetabulum are relatively uncommon, but as they involve the major weight bearing joint in lower extremity, they assume great clinical importance. The displaced acetabular fracture fragments result in hip joint incongruity which in turn leads to abnormal pressure distribution over the articular cartilage surface. This may lead to accelerated breakdown of the articular cartilage, resulting in disabling irreversible arthritis of hip joint. The aim of treatment of these difficult acetabular fractures is concentric reduction of femur head under the weight bearing dome of acetabulum resulting in anatomic reduction and followed by a stable fixation. This can be achieved only by adequately exposing the acetabulum and by rigid internal fixation. In our series 20 patients were included. Majority of the patients were males with mean age of 43.85±16.88 years. Most common mechanism of injury was road traffic accident. Right side was most affected. Most of the cases were isolated injuries. Majority of the cases had no complications. At the final follow up, most of the cases had Excellent follow-up according to Modified Merle d’Aubigne and Postel score. Surgical management of Anterior column with posterior hemitransverse fracture of acetabulum gives excellent outcomes with least number of complications.
References
Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-46.
Guyton JL, Perez EA. Fractures of acetabulum and pelvis. Canale and Beaty. Campbell's Operative Orthopaedics. 11th ed. Mosby: Elsivier; 2007: 3306.
Tile M. Fractures of the pelvis and acetabulum. 2nd ed. Baltimore: Williams and Wilkins; 1996.
Routt ML, Swiontkowski MF. Operative treatment of complex acetabular fractures. Combined anterior and posterior exposures during the same procedure. J Bone Joint Surg Am. 1990;72(6):897-904.
D'aubigne R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36-A(3):451-75.
Letournel E, Judet R. Fractures of the Acetabulum. 2nd ed. New York, NY: Springer-Verlag; 1993.
Mears DC, Velyvis JH, Chang CP. Displaced acetabular fractures managed operatively: indicators of outcome. Clin Orthop Relat Res. 2003;(407):173-86.
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. 1996;78(11):1632-45.
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.
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.
Pennal GF, Davidson J, Garside H, Plewes J. Results of treatment of acetabular fractures. Clin Orthop Relat Res. 1980;(151):115-23.
Kreder HJ, Rozen N, Borkhoff CM, Laflamme YG, McKee MD, Schemitsch EH, et al. Determinants of functional outcome after simple and complex acetabular fractures involving the posterior wall. J Bone Joint Surg. 2006;88:776-82.
Alonso JE, Davila R, Bradley E. Extended iliofemoral versus triradiate approaches in management of associated acetabular fractures. Clin Orthop Relat Res. 1994;(305):81-7.
Kaempffe FA, Bone LB, Border JR. Open reduction and internal fixation of acetabular fractures: heterotopic ossification and other complications of treatment. J Orthop Trauma. 1991;5(4):439-45.