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Results of 75 Consecutive Patients With An Acetabular Fracture

1994; Lippincott Williams & Wilkins; Volume: 305; Linguagem: Inglês

10.1097/00003086-199408000-00008

1528-1132

Victor A. de Ridder, Sam de Lange, L.M. Kingma, Mike Hogervorst,

Hip and Femur Fractures

From 1988 to 1991, 75 consecutive patients with an acetabular fracture were treated. Follow up was for a minimum of 2 years (average, 3 years; range, 2-5 years). Sixty five patients had a solitary acetabular fracture, and in 10 the acetabular fracture was associated with a pelvic fracture (52 men and 23 women; average age, 46 years; range, 17 to 99 years). Twenty four patients were treated nonoperatively (average age, 46 years; range, 12 to 99 years), and 51 underwent surgery (average age, 45 years; range, 17 to 92 years). The indications for surgery were: displacement of the fracture of > 2 mm; an intraarticular fragment interfering with joint movement; posterior instability of the joint with a luxating femoral head; insufficient roof arc; or to prepare the joint for total hip replacement. The patients were classified according to Letournel. Nonoperative treatment consisted of traction or nonweightbearing mobilization during an average period of 2 weeks. The surgical approaches used were: the Kocher-Langenbeck (22); the ilioinguinal (18); and the extended iliofemoral (4). More than 1 approach was used in 3 cases; external fixation was used in 4. All patients received prophylactic treatment of indomethacin. Six developed heterotopic ossification. Preoperatively, 6 patients had a paresis or paralysis from which 5 recovered. Pre- and postoperative nerve lesions occurred in 3 patients from which 2 recovered. One patient died perioperatively of pulmonary embolus. In 2 patients a collapse of the posterior wall resulted in a total hip replacement. The results were good to excellent according to the d'Aubigne scale in 76% of all patients.