Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures.

This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016. Functional and radiographic outcomes, and complication were considered as main outcomes.

A total number of 79 patients completed the study. Fifty-five patients were operated through Kocher-Langenbeck approach, and 18 were operated through the standard ilioinguinal approach, and 6 patients were operated through the standard ilioinguinal approach combined with Kocher-Langenbeck approach. The mean follow-up of patients was 45.6 months. The average operative time was 162.4±78.5 min, and the median blood loss was 500 ml. Functional results were excellent in 41 patients (51.9%), good in 12 (15.2%), fair in 13 (16.5%), and poor in 13 patients (16.5%). Radiologic results were excellent in 27 cases (34.2%), good in 17 cases (21.5%), fair in 18 cases (22.8%), and poor in 16 (16.5%). Osteoarthritis of hip (60.8%) and AVN of head of femur (22.8%) were two most common complications. In addition, there wasn't any significant difference between surgical approaches regarding clinical and radiographic outcomes.

The operative treatment for acetabular fractures gives universally satisfactory results. Thereafter, this study provides evidence that ilioinguinal approach is a good choice for anterior fractures, Kocher-Langenbeck is a good choice for posteriors fractures, and combined approach may be a good choice in the management of acetabular fractures involving two columns.