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Displaced acetabular fractures.
1University of Southern California County General Hospital, Dept. of Orthopaedics, Los Angeles 90033.
Clinical Orthopaedics and Related Research
|May 1, 1988
Summary
Displaced acetabular fractures in young adults require careful treatment decisions. Open reduction and internal fixation yield good results, but closed treatment may suffice for select patients.
Area of Science:
- Orthopedic Surgery
- Trauma Care
Background:
- Displaced acetabular fractures commonly affect young adults due to high-energy trauma.
- These fractures can lead to significant posttraumatic arthritis and long-term disability.
Purpose of the Study:
- To evaluate the effectiveness of surgical approaches for displaced acetabular fractures.
- To identify factors correlating with satisfactory clinical outcomes.
Main Methods:
- Prospective study of 121 patients with displaced acetabular fractures.
- Utilized Kocher-Langenbeck, ilioinguinal, and extended iliofemoral surgical approaches.
- Employed fracture tables and specialized instruments for reduction and fixation.
Main Results:
- Satisfactory operative reduction was the strongest predictor of good clinical results.
- The study achieved 80% satisfactory clinical outcomes.
- Complications included 3% infection rate and 5% nerve palsy incidence.
Conclusions:
- Open reduction and internal fixation are indicated for most displaced acetabular fractures.
- Appropriate surgical approach selection is crucial for successful reduction.
- Closed treatment can be effective in carefully selected cases.