KUMJ | VOL. 12 | NO. 4 | ISSUE 48 | OCT-DEC, 2014
Acetabular Fracture: Retrospective Analysis of Thirty Three Consecutive Cases with Operative Management.
Shrestha D, Dhoju D, Shrestha R, Sharma V
Abstract: Background
With the development of better imaging modalities including 3D CT scan and
availability of technical expertise, operative management is increasingly performed
for acetabular fracture but many patients in developing countries like Nepal, are still
being treated with prolonged skeletal traction.
Objective
To analyses epidemiology, types of acetabular fracture and functional and radiological
outcome of patients with acetabular fracture treated with open reduction and
internal fixation (ORIF).
Method
Inpatients hospital records of patients treated with ORIF in between June 2007
to June 2014 were evaluated. Patient’s demographic data, mode of injury, injury
hospital interval, injury surgery interval, associated injuries, surgical approach,
total hospital stay and peri and post-operative complications were recorded and
radiological and functional outcomes were evaluated.
Result
Thirty three patients (Male: 24 Female: 9) with average age 39 years (range: 21 to
65 years) were operated for acetabular fracture. Twenty one patients (63%) had
injury related with motor vehicle accidents and nine (24%) of them had motorbike
accidents. Injury hospital interval ranges from 7 to 36 days. Average injury-surgery
interval was 21 days and average hospital stay was 22 days. Bicolumnar fractures
were found in 15. Nine patients had dislocation of hip and 15 had concomitant other
injuries. Biculumanr fixation was performed in 15 patients, posterior column and
or wall in nine with Kocher Langenbeck approach and anterior column and or wall
in other nine with ilio-inguinal approach. Radiological reduction was anatomical in
18; excellent/good functional outcome was in 26 and radiological outcomes were
excellent in 14. Three patients had developed Hypertopic ossification. Follow up
period ranged from 6 to 48 months and 15 patients (45%) had follow up >2 years.
Conclusion
Acetabular fractur can be effectively managed with ORIF and have predictable and
comparable functional and radiographic outcomes. Upgrading the existing facilities
and training of orthopedic surgeon for acetabular fracture management is important
to shorten injury-surgery interval due to lack of such facilities.
Keyword : Acetabulum, internal fixation, open reduction
