Critical analysis of prognostic factors in fracture dislocation of hip

Abstract

Background: Fracture dislocation of the hip is an absolute orthopaedic emergency which is increasing day by day. There are various factors determining the functional outcome in these patients. The aim of the study is to critically analyse various prognostic factors and effect of acetabular fracture index (AFI), posterior acetabular arc angle (PAAA), head wall index (HWI) on functional outcome as well as importance of timing of relocation in development of degenerative arthritis. Materials and methods: It is a prospective study including 23 patients, above 20 years of age with study period from January 2015 to May 2018. All the patients were evaluated clinically using modified Merle d` Aubigne Postel score and radiologically by Matta et al. criteria. The average follow up period was 2 ½ years. Results: 48% of cases had excellent outcome, 31% of cases had good and 13% of cases had fair outcome. 8% of cases end with poor outcome. The quality of reduction was anatomical in 61% of cases and imperfect in 30% of cases and poor in 9% of cases. The functional outcome was good in patients with higher value of acetabular fracture index, posterior acetabular arc angle and lesser head wall index. Conclusion: The quality of reduction of fracture remains the most important factor when compared to AFI, PAAA, HWI in determining the functional outcome. The timing of relocation of hip may be of less significance in fracture dislocation.