ASSOCIATED POSTERIOR PELVIC INJURY PATTERNS IN TRANSVERSE-ORIENTED ACETABULAR FRACTURE

Introduction: Our study analyzes the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse oriented acetabular fractures. Material and methods: 51 transverse oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups which were formed according to acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality. Results: There were associated posterior pelvic injuries in 34 (66.7%) of the total 51 patients. There were 32 sacroiliac separations throughout the 34 patients with associated posterior pelvic injury, and among these, ipsilateral sacroiliac separations were higher. According to computerized tomography guided measurements, 16 SI separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were between 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). Acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients and poor in 5 (14.7%) patients among the 34 patients with associated posterior pelvic injury. The reduction rates in isolated acetabular fractures revealed 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor reductions Rate of anatomic reduction was significantly higher when sacroiliac separation degree was ≤0.5 cm (p:0.027). Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most of the transverse oriented acetabular fractures and this may influence the acetabular reduction quality.