Acetabular fractures –Clinical outcomes of surgical management

Introduction : The fractures of acetabulum concern 2% of fractures and it is difficult to be diagnosed and treated.Improvements in automobile safety, pre-hospital care, resuscitation and transport as well as standardized protocols for treatment have all contributed to improved survival after these devastating injuries Materials and methods : The operative treatment of acetabular fractures was performed in Vinayaka Mission Kirupananda Variyar Medical College and Hospital from July 2010 to July 2019. 32 patients had an open reduction and internal fixation of an acetabular fracture. 25 were males and 7 were females, with an age ranging from 28 to 62 years (average: 36.7 years). The mechanism of injury was a motor vehicle accident in most cases (85%). The fractures were classified with Judet-Letournel classification. The patients were operated upon within 1-8 days (average: 4 days). The Kocher-Langenbeck surgical approach was used in 22 cases and ilioinguinal approach in 10 patients. Osteosynthesis was achieved with either lag screws alone or with a combination of lag screws and a buttress plate. Follow-up ranged from 6 months - 9 years (average: 3.8 years). Results: Clinical evaluation according to the D' Aubigne-Postel scoring system gave 23 excellent (71.9%), 6 good (18.8%), 2 fair (6.3%) and 1 poor (3.1%) results. Early postoperative complications included 1 case of unexplained bleeding through drain tube for 8 days and superficial wound infection in another 3 patients. Conclusion : Operative treatment of acetabular fractures although demanding, bears very good results.