Long-term outcome of operative management of delayed acetabular fractures.

BACKGROUND

Surgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma. The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.

METHODS

The operative approaches, procedures, results, and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital. Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.

RESULTS

Sixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years). Excellent functional results were observed in 10 hip joints, good results in 40, fair results in 11, and poor results in nine. The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head, a time beyond 42 days from injury to operative management, and dislocation of femoral head during the injury. Some of the problems, which were observed included postoperative infection in two hips, iatrogenic sciatic nerve injury in eight hips, traumatic arthritis in 15 hips, heterotopic ossification in 17 hips, and necrosis of the femoral head in six hips.

CONCLUSION

A careful selection of operative indications for delayed acetabular fractures in combination with a proper operative approach and appropriate reduction and fixation could guarantee relatively good results.