Outcome of surgically treated acetabular fractures: risk factors for postoperative complications and for early conversion to total hip arthroplasty.
Humans
Arthroplasty, Replacement, Hip
/ adverse effects
Retrospective Studies
Acetabulum
/ diagnostic imaging
Treatment Outcome
Hip Fractures
/ surgery
Fractures, Bone
/ surgery
Postoperative Complications
/ epidemiology
Fracture Fixation, Internal
/ adverse effects
Spinal Fractures
/ surgery
Risk Factors
Acetabular fracture
Hip arthroplasty
ORIF
Polytrauma
Postoperative complications
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
13
09
2022
accepted:
27
11
2022
medline:
27
7
2023
pubmed:
11
12
2022
entrez:
10
12
2022
Statut:
ppublish
Résumé
The gold standard of Acetabular fractures treatment is open reduction and internal fixation (ORIF). Our purpose is to assess the short- to medium-term outcomes and complications of surgically treated acetabular fractures. We analysed factors influencing clinical outcomes, incidence of complications and predictors of conversion in total hip arthroplasty (THA). We retrospectively analysed 102 patients with acetabular fracture surgically treated between December 2017 and September 2020. We evaluated the quality of reduction with x-ray measuring residual displacement, classified into 3 groups (Matta Radiological Score). At the final follow-up, radiographs were graded according to Matta's Radiological Outcome Grading, and the clinical outcomes were graded using Oxford Hip Score (OHS). 62 patients were enrolled. OHS was influenced by quality of reduction (p = 0.031), injury severity score (ISS) (p = 0.003) and BMI > 30 (p < 0.0001). The late sequelae were heterotopic ossification (HO) in 13 patients, osteoarthritis (OA) in 22 and avascular necrosis (AVN) in 4. HO was significantly affected by posterior approach and ISS > 15. The analysis showed a correlation between AVN and posterior hip dislocation. OA had a correlation with postoperative quality of reduction (p = 0.014). Eight patients required THA with a significant correlation between THA and posterior dislocation, isolated posterior wall fracture and ISS > 15. A high rate of patients with acetabular fractures still develop complications and require THA. Identification of predictors for poor outcome may help to inform surgical decision-making regarding options of plate osteosynthesis or 'Fix and Replace', to avoid poor outcomes and early revision surgery.
Identifiants
pubmed: 36495349
doi: 10.1007/s00590-022-03451-4
pii: 10.1007/s00590-022-03451-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2419-2426Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
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