Clinical, radiological and functional outcome following surgical fixation of acetabular fractures

Abstract

: Acetabular fractures are commonly caused by high-velocity injuries that can result from falls from heights or motor vehicle accidents. Surgical fixation has been found to result in improved clinical outcomes such as reduced pain, improved range of motion, and improved alignment and stability of the joint. Patients with pelvic injuries often have associated multiple systemic injuries, adding to the overall morbidity and mortality. Treating fractures in the pelvic area involving the acetabulum can be complicated, significantly when displaced. Proper exposure of the acetabulum and rigid internal fixation is necessary to achieve the main goals of treatment, which are to reconstruct the articular surface and promote early mobilization. Closed methods make it nearly impossible to restore the articular surfaces completely and obtain enough stability for early hip motion.: This study assesses the functional outcome of open surgical fixation of acetabulum fractures involving single or both columns. : Our study looked at patients over 18 years old with displaced fractures, and we treated them using only two approaches: the Kocher Langenbeck approach and the Modified Stoppa approach. Radiological and functional examinations were performed monthly for the first six months. Postoperative radiological assessments were graded using Matta's criteria, and functional outcomes were assessed using modified Merle d' Aubigné and Postel Hip Score.: We treated displaced acetabular fractures using only two non-extensile approaches: the Kocher Langenbeck approach and the Modified Stoppa approach. In most cases (67%), we used only one method, except in 7 patients. Our treatment achieved an impressive 85% rate of good to excellent outcomes (18 out of 21). Our study found that the delay in surgery time significantly impacted Merle d' Aubigne scores (P<0.05), leading to complications and lower functional outcomes in complicated cases. The functional and radiological outcomes were also significantly affected by the mechanism of injury, time between injury and surgery, initial degree of displacement, and quality of reduction. Surgical fixation of displaced acetabular fractures can yield better results with good imaging facilities, experienced surgeons, better instrumentation, and good perioperative care. However, further studies with an adequate sample size are needed to validate our findings. A study on the outcome of acetabular fractures treated surgically found that early surgical intervention and good perioperative care can lead to satisfactory functional outcomes. The study used only two non-extensile approaches and achieved an 85% rate of suitable to excellent outcomes. The study also observed that the mechanism of injury, time between injury and surgery, initial degree of displacement, and reduction quality significantly affected functional and radiological outcomes. However, further studies are needed to validate the findings.