BACKGROUND: The purpose of this study was to determine the long-term outcome of conservatively managed acetabular fractures involving the weight-bearing dome, which otherwise deserves an operative treatment. METHODS: Thirty-two patients with displaced acetabular fractures (>3 mm displacement) involving the weight-bearing dome and not associated with unstable pelvic ring injuries met the inclusion criteria for this study with a minimum of 2 years of follow-up evaluation. They were assessed using the Merle de'Aubigne and Postel clinical scoring and Matta's radiologic scoring system. The mean duration of follow-up was 4.1 years (2-12 years). RESULTS: The reducibility of acetabular fractures by conservative management stood at 18 of 32 (56.3%) synchronizing with 18 of 32 (56.3%) good to excellent clinical score. The mean clinical score was 14.25 +/- 3.41 of a total score of 18. In patients with good fracture reduction, good to excellent results were seen in 83.3% cases. The radiologic grade was good to excellent in 50% cases with good clinicoradiologic correlation (p = 0.0001). CONCLUSIONS: Acetabular fractures involving the weight-bearing dome if reduced by closed means can be maintained by heavy lateral and longitudinal traction resulting in good clinicoradiologic outcome comparable with operative management.
BACKGROUND: The purpose of this study was to determine the long-term outcome of conservatively managed acetabular fractures involving the weight-bearing dome, which otherwise deserves an operative treatment. METHODS: Thirty-two patients with displaced acetabular fractures (>3 mm displacement) involving the weight-bearing dome and not associated with unstable pelvic ring injuries met the inclusion criteria for this study with a minimum of 2 years of follow-up evaluation. They were assessed using the Merle de'Aubigne and Postel clinical scoring and Matta's radiologic scoring system. The mean duration of follow-up was 4.1 years (2-12 years). RESULTS: The reducibility of acetabular fractures by conservative management stood at 18 of 32 (56.3%) synchronizing with 18 of 32 (56.3%) good to excellent clinical score. The mean clinical score was 14.25 +/- 3.41 of a total score of 18. In patients with good fracture reduction, good to excellent results were seen in 83.3% cases. The radiologic grade was good to excellent in 50% cases with good clinicoradiologic correlation (p = 0.0001). CONCLUSIONS: Acetabular fractures involving the weight-bearing dome if reduced by closed means can be maintained by heavy lateral and longitudinal traction resulting in good clinicoradiologic outcome comparable with operative management.
Authors: Helene Ernstberger; Philipp Pieroh; Andreas Höch; Christoph Josten; Steven C Herath; Georg Osterhoff Journal: Eur J Trauma Emerg Surg Date: 2020-04-08 Impact factor: 3.693