An analysis of surgical management of acetabular fractures

Abstract

With increase in number of high-speed road traffic accidents the incidence of acetabular fracture is increasing. Historically satisfactory results after non operative treatment of acetabular fractures were obtained only in a minority of cases (13-30%). Non operative treatment options include traction and early mobilization with progressive weight bearing. Unsuccessful outcomes after non operative treatment were mostly related to early posttraumatic arthritis likely due to articular incongruity, hip joint instability, and muscle dysfunction. In our study, all the acetabular fractures are classified using standard investigations, operatively managed in indicated cases and followed up post-operatively with regards to improvement in clinical and radiological outcome. Out of 50 patients, 12 patients had excellent result, 24 patients had good result, 9 patients had fair result, and 5 patients had a poor result. Aims and Objectives 1. To study and analyze the outcomes of open reduction and internal fixation in patients with acetabular fractures in terms of radiology, clinical and functional outcomes. 2. To study the role of early range of motion exercises in the functional outcome.3. To study the complications associated with the surgical approaches. Materials and Methods 1. Type of study: Descriptive, case series, comparison study, partly retrospective and prospective. 2. The study was done to assess the clinical, radiological and functional outcome of patients with acetabular fractures treated with open reduction and internal fixation at Goa Medical College. 3. Study setting: Inpatient ward no 103,104,105, under Department of Orthopaedics, Goa Medical College. 4. Methods: All fractures have been classified using the Letournel and Judet classification. All the cases were followed up post operatively and were analyzed for radiological, functional and clinical outcome. The radiological outcome was evaluated with radiograph pelvis AP view, Obturator oblique view and Iliac oblique views. The functional outcome was evaluated with Merle d’Aubigne and Postel modified clinical grading system and Harris hip score.