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Operative time in acetabular fracture fixation: predictors and impact on postoperative outcomes
Mohammad Daher1, Ali Ghoul2, Bryan Youssef2
1Hôpital Paris Saint-Joseph, Paris, France. mohdaher1@hotmail.com.
Summary
Prolonged operative time in acetabular fracture surgery is linked to complex fractures and high-energy trauma, not worse patient outcomes. Shorter surgeries were associated with dislocations, but longer procedures did not increase complications like infection or arthritis.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Skeletal Reconstruction
Background:
- Acetabular fracture fixation is complex, with operative time often used as a proxy for difficulty and complication risk.
- The factors influencing prolonged operative time and its independent impact on outcomes remain unclear.
Purpose of the Study:
- To identify preoperative factors associated with prolonged operative time in acetabular fracture fixation.
- To determine if longer operative time independently affects postoperative outcomes.
Main Methods:
- Retrospective review of 441 patients undergoing acetabular fracture fixation with a minimum 3-month follow-up.
- Operative time dichotomized at the median (127 minutes) into short (≤127 min) and long (>127 min) groups.
Main Results:
- High-energy trauma and associated lesions independently predicted longer operative times (OR 1.9 and 1.8, respectively).
- Dislocations were associated with shorter operative times (OR 0.5).
- Longer operative time did not correlate with increased rates of infection, heterotopic ossification, femoral head necrosis, osteoarthritis, or conversion to total hip arthroplasty.
Conclusions:
- In acetabular fracture fixation, prolonged operative time is primarily driven by fracture complexity (associated lesions) and trauma type.
- Dislocations, often treated with a single posterior approach, correlate with shorter operative times.
- Extended operative duration does not appear to worsen key postoperative outcomes.
