Outcome of Operative Treatment of Complex Acetabular Fractures :Clinico-Radiological Correlation
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 12
Abstract
Background: Surgical management of acetabular fractures is a complex area of orthopaedics that is being continually refined. Due to complex surgical anatomy and displacements often pose diagnostic and surgical dilemmas to the managing orthopaedic surgeon. Aims: the aim of this study is to observe outcome of surgical treatment of complex acetabular fractures both clinically and radiologically and correlate radiological finding with clinical outcome at followups. Materials And Methods: This pilot project was conducted in a tertiary care cente of eastern india with institutional ethical clearance and informed consent of the subjects. Ten patients were selected according to inclusion criteria. They were followed up after operative management in the institution for 18 months. Results:There were 10 patients who underwent surgical fixation for acetabular fractures and available for review with minimum 18 months follow up. There were 2 females and 8 male patients. Mean age at surgery was 37 years. Mechanism of injury included road traffic accidents in 8 patients (80%) and fall from height ( 24 ft) in 2 patients(20%). No other associated injuries were present as per inclusion criteria. There were 4 patients with anterior column fracture, 4patients with post wall fracture, 1 patient with posterior column with post wall fracture, 1 patient with transverse fracture pattern. One of them had undisplaced anterior column fracture with post wall and column fracture. 7 patients were (70%) operated at first week of admission, 2(20%) were operated on 2nd week, one(10%) was treated late at end of 2nd week. Mean time of operation from accident is 10days. No patient in this study was found to have any post operative neurovascular compromise. 1 patient had surgical site infection on 2nd week of hospital stay, managed with wound debridement and intravenous antibiotics. Grade 1 pressure sore noted in 1 patient. No DVT was there in the study group. 1 patient presented later with post traumatic hip osteoarthritis at 18month follow up. Time for patients with uncomplicated surgery to heal and return to full weight bearing underwent an average of 16.3 weeks. Anatomical reduction were achieved in 70 % patients as shown at immediate post reduction radiographs. Radiological outcome at follow up in 18 months showed excellent in 60% and good result in 30% patients. No heterotopic ossification noted except 10% patient presented with collapse of femoral head and hip arthritis late. Clinical outcome is good in 60% patients with no residual hip pain and 30% patients have excellent outcome those can return to pre injury occupation. Conclution: Though surgical approaches for these fractures are complicated and fracture orientation is often complex, adequate reduction is achievable in majority of cases. Therefore operative treatment is a good choice for treatment of these fractures. And radiological status of the fracture correlates well with functional outcome.
Authors and Affiliations
Dr Apurba Gorain, Dr Soudip Sinha, Dr Soumya Ghosh, Dr Pradip Kumar Ghosh
Keywords
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- EP ID EP251420
- DOI 10.9790/0853-1612089498
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