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Surgically Treated Isolated Posterior Wall Fractures of Acetabulum: A Short Term Outcome Study | ||
| Iraqi Postgraduate Medical Journal | ||
| Article 1, Volume 18, Issue 3, 2019, Pages 188-196 PDF (0 K) | ||
| Authors | ||
| Mohammed Hatem Salal; Mohammed Kadhim Hamad; Ali Bakir Al-Hilli | ||
| Abstract | ||
| BACKGROUND: Isolated posterior wall fractures are common injuries of the acetabulum, anatomical reduction and stable fixation are the goals of operative treatment when indicated, outcomes of surgical treatment depend on many patient`s and fracture`s factors. OBJECTIVE: To evaluate the functional and radiological outcomes of surgically treated isolated posterior wall fractures of acetabulum and the effect of patient`s and fracture`s variables on the outcomes in a short term follow up. MATERIALS AND METHODS: Prospective study on twenty patient who met the inclusion criteria treated surgically for isolated posterior wall fractures of acetabulum at Baghdad Medical City Directorate from July 2014 to December 2016 with at least one year follow up. All patients were evaluated clinically with Modified Merle d`Aubigne score and Harris hip score, and radiologically with Matta`s radiological outcome grading. The effect of gender, BMI, associated dislocation, timing of reduction of dislocation, timing of surgery, and quality of reduction on the outcomes were evaluated. RESULTS: The mean final Modified Merle d`Aubigne score was 15.65 (range, 8 to 18) with excellent and good results in 16 patient (80%), fair and poor results in 4 patients (20%). The mean final Harris hip score was 89.2 (range, 65 to 100), with excellent and good results in 16 patient (80%), fair and poor results in 4 patients (20%).The final radiological outcome results were excellent and good in 17 patient (85%), fair and poor in 3 patients (15%). The functional and radiological outcomes were significantly affected by the quality of fracture reduction ( p=<0.0001, p=0.0009) respectively. In addition, the functional outcome was significantly affected by the presence of dislocation (p=0.019), delay in reduction of dislocation (p=0.0026), and delay in surgery more than 2 weeks (p=<0.0001). However, gender, and BMI did not show clear effects on the functional outcome ( p=0.938, p=0.172) respectively. CONCLUSION: Satisfactory outcomes can be obtained with open reduction and internal fixation of isolated posterior wall fractures of acetabulum in short term follow up. Anatomical reduction strictly correlated to both functional and radiological outcomes with favorable results. Early reduction of hip dislocation within 12 hours and early surgery within two weeks had favorable functional outcome while the presence of hip dislocation adversely affects the functional outcome. However differences in gender and body mass index did not clearly affected the functional outcome. | ||
| Keywords | ||
| posterior wall acetabular fractures; Surgical treatment | ||
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