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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 168 - 168
1 Feb 2004
Panousis K Goutzanis G Velentzas P Fandridis E Kokalis Z Gianoulis F Tsifetakis S Pilichos I
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Aim: The purpose of this study is to determine the outcome in patients with acetabular fractures treated either conservatively or surgically

Method: From 1990ā€“2000, we treated 152 patients with 158 acetabular fractures. 63 patients were treated nonoperatively and 95 operatively. According to Tile classification there were 70 type A, 52 type B, 36 type C fractures. Mean follow up was 90 months (23ā€“151 months). Indications for surgery were fracture displacement of more than 2mm, hip joint instability, intrarticular fragments and ipsilateral femoral fracture. Surgical approaches used included the kocher-Langenbeck and the triradiate approach. Follow up consisted of radiological examination and functional assessment using Merle dā€™ Aubigne score.

Results: 53 conservatively treated patients followed up. 39 (73.6%) had excellent and good results and 14 (26.4%) fair and poor results due to excessive fracture comminution, severe osteoporosis, or they were too sick to be operated on.

83 operatively treated patients with 85 fractures were followed-up. Anatomic reduction was achieved in 57 fractures, satisfactory in 18 and poor in 10 fractures.

Functional outcome was excellent or good in 60 (72.3%) patients and fair and poor in 23 (27,7%).The complications were 3 wound infections, 4 cases of femoral head osteonecrosis, 3 cases of secondary loss of reduction and 5 cases of significant ectopic ossification.

Conclusion: The outcome of these difficult fractures depends on restoration of hip joint congruity and stability and correlates closely to radiographic result.