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[Acetabular fractures: short-term results]
V Estrems-Díaz1, L Hernández-Ferrando, J Balaguer-Andrés
1Servicio de Cirugía Ortopédica y Traumatología, Consorcio Hospital General Universitario de Valencia, Valencia, España. vicenteestrems@hotmail.com
Objective:
To evaluate the results of surgical treatment of displaced acetabular fractures, and to discern which variables influence the final radiological and clinical outcome.
Methods:
We retrospectively analyzed 23 patients who underwent open reduction and internal fixation of acetabular fracture with a mean age of 40.4 years (17-72 years). Mean follow-up was 4 years (1.5-7.5 years). According to Judet and Letournel classification, we operated 10 simple fractures (43.5%) and 13 complex (56.5%), with both-column fractures being the most common type (8 hips). We evaluated the quality of reduction achieved, the clinical results and the occurrence of coxarthrosis.
Results:
We obtained anatomic reduction of the lesion in 12 cases (52%), in 7 (30%) residual displacement was less than 2mm, and in 4 patients (17%) greater than 2mm. According to Harris' score, the clinical outcome was excellent or good in 18 cases (78%) and fair or poor in 5 (22%), getting worse in complex fractures and when we do not reach an anatomic reduction of the injury. Six patients (26%) developed moderate or severe degenerative changes during follow-up. The degree of postoperative reduction obtained was identified as the main predictor of the development of post-traumatic osteoarthritis.
Discussion And Conclusions:
The acquisition by open reduction and internal fixation of an accurate congruence between the femoral head and acetabulum is essential to achieve good long-term results.
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