Surgical outcome of Unstable Acetabular Fractures: A Prospective study

Arun Anand, P (2012) Surgical outcome of Unstable Acetabular Fractures: A Prospective study. Masters thesis, Madurai Medical College, Madurai.

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Abstract

We reviewed the radiological and functional outcome of open reduction and internal fixation of 18 unstable acetabular fractures in our institution from July 2009 to November 2011. Pre operative evaluation was done with Letournel and Judet views, Axial CT scan and 3D reconstruction scans. The factors affecting the radiological and functional outcome of surgically treated patients were analyzed. The anatomical reduction is found to be the most important and consistent factor affection the outcome. The relationship between the factors such as age, initial displacement, associated injuries, and the time interval between injury and surgery were also evaluated. The radiological outcome was assessed using Matta’s criteria while the functional outcome was assessed using Merle d’ Aubignẻ and Postel modified score. The post operative fracture reduction as measured on the three plain radiographs were graded as anatomical in 7(39%), imperfect in 6(34%) and poor in 5(28%) cases. The functional outcome which was evaluated with Merle d’ Aubigne’ and Postel modified score was found to be excellent in 4 patients, good in 6 patients, fair in 4 patients and poor in 4 patients. The radiological outcome was strongly associated with the functional outcome (p-0.0044) which strongly supports the point that achieving anatomical reduction is the most important aspect. The findings in our study suggest that the achievement of anatomical reduction is the most important factor affecting the outcome. None of our patients had iatrogenic nerve injury. We encountered complications such as infection (3 out of 18), posterior dislocation of hip (1 out of 18) and plate breakage (1 out of 18). To conclude, it involves a long learning curve and the treatment should be done in a specialized tertiary care centre which has a specialized team for managing the acetabular fractures. The goal of the surgical treatment should be to produce a functional mobile painless joint that continues to function till the rest of life for the patient.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acetabular fractures ; anatomical reduction ; Letournel and Judet views ; Kocher Langenbeck ; posterior wall.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 15:59
Last Modified: 17 Sep 2017 06:40
URI: http://repository-tnmgrmu.ac.in/id/eprint/2948

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