Surgical treatment of acetabular fracture

Clinicalradiological results and its complications

Abstract

Introduction: acetabular lesions are inusual. Treatment is complex and it requires research center on this condition.
Objective: to analyse for the first time in our country, a series of consecutive cases of surgically treated acetabular fractures, evaluating middle-term clinical and radiological results, studying each complication.
Method: a retrospective analysis of clinical histories, surgical forms and X-rays was performed for 42 patients who underwent surgery in two centers (Instituto Nacional de Ortopedia y Traumatología [INOT] and Banco de Prótesis), from July 2001 through August 2007. The different factors affecting the evolution of patients were studied.
Results: the negative clinical and radiological results, as well as the emergence of complications were closely related to the type of lesion (worse in these complex lesions),to poor reductions, to age older than 40 years old, to delay in surgery and to surgeons with lower number of surgeries performed (70% compared to 35% more experienced surgeons). Five cases required hip arthroplasty, three of which resulted form severe articular infection.
The eight deep infections evidence negative clinical-radiological results. Other complications included two vascular lesions, six epiphyseal necrosis and seven sciatic nerve palsy (post-traumatic or post-surgery).
Conclusions: they are serious lesions, difficult to treat and present high levels of complications, what dramatically drops when young patients are operated early, when patients undergo simple lesions that do not include hip luxation, and when they are treated by more experienced surgeons who manage to perform anatomic reduction