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Acetabular fractures with marginal impaction: mid-term results
P V Giannoudis1, N K Kanakaris, E Delli Sante
1Academic Department of Trauma & Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, UK. pgiannoudi@aol.com
The Bone & Joint Journal
|February 1, 2013
Summary
Marginal acetabular impaction fractures in adults can achieve satisfactory medium-term results with joint elevation. However, secondary collapse is a risk, with increasing age and inferior impaction linked to worse pain.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Hip Reconstruction
Background:
- Acetabular fractures with marginal impaction pose challenges in achieving optimal outcomes.
- Understanding the long-term sequelae of these injuries is crucial for surgical planning and patient management.
Purpose of the Study:
- To evaluate the medium-term functional and radiological outcomes of adult patients with marginal impaction of acetabular fractures treated with acetabular reconstruction.
- To identify factors influencing pain and functional results in this patient cohort.
Main Methods:
- A retrospective review of 60 adult patients with marginal acetabular impaction fractures treated over five years.
- Fractures classified using the Judet and Letournel system, with topographic assessment of articular impaction.
- Functional outcomes assessed using EuroQol 5-D, and radiological outcomes graded using Matta's criteria.
Main Results:
- At a mean follow-up of 48 months, 55% of hips showed excellent radiological results.
- 44 hips (73.3%) achieved anatomical reduction, though this was lost in 25.8%.
- Increasing age and inferior impaction location were associated with worse pain outcomes; 11 patients required further surgery, including six total hip replacements.
Conclusions:
- Elevation of the articular impaction in acetabular fractures can lead to joint preservation and satisfactory medium-term functional results.
- Secondary collapse remains a potential complication, necessitating careful patient selection and monitoring.
- Factors such as age and impaction location significantly influence long-term pain and function.
