THE OUTCOME OF SURGICALLY TREATED DISPLACED ACETABULAR FRACTURES AT A MINIMUM OF 10 YEARS FOLLOW UP.

Abstract

Purpose: To assess the long term radiological, clinical and psychological outcome of patients treated surgically for displaced acetabular fractures.

Methods: Over 79 patients were followed up in our outpatient clinic. AP pelvis and Judet view radiographs were taken and evaluated. This was followed by a detailed history and clinical examination. Outcome recorded using the modified Merle d’Aubigne scale. The SF36v2 questionnaire was also administered.

Results: Using the modified Merle d’Aubigne scale:

Excellent 18%, Good 51%, Fair 13% and Poor 18%. Using the SF36v2 health questionnaire (Norm based scoring 1998 US population where 50 is the average score):Transformed physical score (PCS) 44.54 and transformed mental score (MCS) 50.27.

Conclusions: The results represent the learning curve for a single surgeon specifically trained in this speciality. These results compare favourably with those of Matta (JBJS Nov 1996 78A), whose ‘excellent’ & ‘good’ results with a shorter follow up period was 76%. Letournel’s results at 12 years showed a 69% ‘excellent’ & ‘very good’ grade using a slightly different grading system.We have many patients in the ‘good’ grade that have normal walking and range of motion, but miss the ‘excellent’ grade because of slight or intermittent pain. |The results seem to support the surgical treatment of displaced ace-tabular fractures. Most studies show results for short term follow up. Long term follow up studies have implications in predicting the future with regard to medical legal claims.